jamunjar-logo
whatsapp
cartmembermenu
Search for
"test & packages"
"physiotherapy"
"heart"
"lungs"
"diabetes"
"kidney"
"liver"
"cancer"
"thyroid"
"bones"
"fever"
"vitamin"
"iron"
"HTN"

Neurofibroma Biopsy - XL

Biopsy
image

Report in 288Hrs

image

At Home

nofastingrequire

No Fasting Required

Details

Histopathology of neurofibromas.

₹888₹1,269

30% OFF

Neurofibroma Biopsy - XL

  • Why is it done?
    • Definitive diagnosis of neurofibromas (benign nerve sheath tumors) to confirm clinical and imaging suspicions
    • Differentiation between localized neurofibromas and other nerve tumors such as schwannomas or malignant peripheral nerve sheath tumors (MPNST)
    • Assessment of suspicious lesions in patients with Neurofibromatosis Type 1 (NF1) to rule out malignant transformation or MPNST
    • Evaluation of large or rapidly enlarging masses that may indicate progression or malignant change
    • Histopathological examination to determine tumor grade, cellularity, and mitotic activity
    • Typically performed when imaging findings are inconclusive or when there are clinical concerns regarding tumor behavior or malignant potential
  • Normal Range
    • Normal Result: Absence of malignancy; benign neurofibroma with characteristic histopathological features including loose fascicles of nerve fibers, fibroblasts, and nerve fibers intermixed without significant cellular atypia or mitotic activity
    • Typical Findings (Benign Neurofibroma): Low to moderate cellularity, myxoid stroma, lack of nuclear pleomorphism, minimal or absent mitotic figures (<1 mitosis per 10 high-power fields), S100 protein positive staining
    • Interpretation Parameters: Results are qualitative, reported as diagnostic impressions rather than numeric values; mitotic rate, cellularity grading, and immunohistochemical profile guide final diagnosis
    • Abnormal Findings: High cellularity, increased mitotic activity (>5 mitoses per 10 high-power fields), nuclear pleomorphism, tumor necrosis, or increased Ki-67 proliferation index suggesting atypical or malignant transformation
  • Interpretation
    • Benign Neurofibroma: Characterized by well-defined fascicles of spindle cells arranged in whorled patterns with prominent myxoid background. Shows low mitotic activity, minimal nuclear atypia, and positive S100 immunostaining. Indicates benign course with favorable prognosis; conservative management typically recommended with imaging surveillance for stability
    • Atypical Neurofibroma: Demonstrates increased cellularity, moderate nuclear pleomorphism, 2-5 mitoses per 10 high-power fields, and elevated Ki-67 index (>5%). Requires closer clinical monitoring and more frequent imaging surveillance. May warrant consideration for surgical intervention depending on location and size; increased risk of eventual malignant transformation compared to typical benign neurofibromas
    • Malignant Peripheral Nerve Sheath Tumor (MPNST): Shows high cellularity, marked nuclear pleomorphism, abundant mitotic figures (>5 per 10 high-power fields), geographic necrosis, and high Ki-67 proliferation index (>10%). Indicates aggressive malignancy requiring immediate multidisciplinary intervention including oncology consultation, surgical resection consideration, and chemotherapy/radiation therapy evaluation. Significantly worse prognosis with need for systemic staging studies
    • Schwannoma vs. Neurofibroma Differentiation: Schwannomas show encapsulation, bilateral S100 staining, and cellular/Antoni A and myxoid/Antoni B regions. Neurofibromas show mixed S100 positivity and intimate nerve involvement. Correct differentiation guides prognosis and treatment planning
    • Factors Affecting Interpretation: NF1 status (increased MPNST risk), specimen adequacy and depth, fixation quality, tumor size, location (deeper tumors carry higher risk), patient age, and presence of clinical symptoms suggesting rapid growth
    • Immunohistochemical Profile: S100 protein, SOX10, p53, Ki-67, EMA, and CD34 staining patterns provide additional diagnostic information. MPNST often shows p53 overexpression and high Ki-67 positivity; loss of INI1/SMARCB1 suggests potential for aggressive behavior
  • Associated Organs
    • Primary Organ System: Peripheral nervous system, specifically nerve sheaths derived from neural crest cells; can occur in any location with nerve tissue including subcutaneous, intramuscular, and deep compartments
    • Common Tumor Locations: Trunk and extremities most common; may involve brachial, lumbar, or sacral plexuses; cutaneous and subcutaneous neurofibromas prevalent in NF1 patients; deep/plexiform neurofibromas can compress adjacent structures
    • Associated Medical Conditions: Neurofibromatosis Type 1 (NF1) syndrome with high lifetime risk of multiple neurofibromas and malignant transformation; sporadic neurofibromas; neurofibromatosis Type 2 (NF2); schwannomatosis
    • Potential Complications of Abnormal Results: Nerve compression causing pain, motor weakness, or sensory loss; vascular compression; functional impairment based on location; malignant transformation in susceptible patients; increased cancer risk affecting treatment planning
    • Systemic Involvement: NF1 patients may have widespread neurofibromas affecting multiple organ systems; malignant transformation can affect prognosis and require whole-body surveillance; may impact cardiac, pulmonary, or gastrointestinal function depending on tumor location and size
    • Genetic Implications: Confirmation of neurofibroma diagnosis may trigger genetic counseling and testing for NF1 mutations in patients without known syndrome; has implications for family screening and surveillance protocols
  • Follow-up Tests
    • If Benign Neurofibroma Confirmed: Baseline MRI imaging for reference; periodic surveillance imaging (typically annually for first 2-3 years); clinical examination for signs of growth or functional compromise; genetic counseling and NF1 gene testing if not previously diagnosed with NF1
    • If Atypical Neurofibroma Identified: More frequent MRI surveillance (every 3-6 months); baseline PET-CT or additional imaging to assess for metastatic disease; oncology consultation; molecular testing for additional prognostic markers; repeat biopsy if imaging shows significant change; close clinical monitoring for symptoms of progression
    • If Malignant Transformation (MPNST) Confirmed: Urgent oncology referral; complete staging studies (chest/abdomen/pelvis CT or MRI, PET-CT); tumor grading and TNM staging; baseline laboratory work (CBC, metabolic panel, LDH); surgical consultation for resection planning; evaluation for chemotherapy and/or radiation therapy candidacy; genetic counseling for NF1 status assessment
    • Additional Diagnostic Imaging: MRI with contrast for detailed anatomic assessment and relationship to surrounding structures; ultrasound for superficial lesions; CT for bony involvement evaluation; PET-CT for aggressive/malignant lesions to assess metabolic activity and distant metastases
    • Molecular and Genetic Testing: NF1 gene sequencing if not previously tested; next-generation sequencing for additional mutations in atypical/malignant cases; fluorescence in situ hybridization (FISH) for chromosomal abnormalities; immunohistochemical staining for prognostic markers (p53, INI1/SMARCB1)
    • Long-term Surveillance Protocols: Regular clinical examinations every 3-6 months; periodic MRI at intervals determined by baseline findings and growth pattern; follow-up imaging at 6 months post-biopsy to establish stability or growth trajectory; annual surveillance imaging for benign lesions; more frequent monitoring for NF1 patients with known syndrome
    • Complementary Clinical Assessments: Neurological examination for functional deficits; electrodiagnostic studies (EMG/NCS) if nerve compression suspected; skin examination for café-au-lait spots and other NF1 features; ophthalmologic examination for optic nerve gliomas in NF1 patients
  • Fasting Required?
    • Fasting Required: No
    • Anesthesia Considerations: If biopsy performed under general anesthesia, standard NPO (nothing by mouth) guidelines apply: typically 6-8 hours for solid food, 2 hours for clear liquids; follow specific instructions provided by anesthesia team
    • Medication Management: Continue routine medications unless specifically instructed otherwise; anticoagulants (warfarin, dabigatran, apixaban) or antiplatelet agents (aspirin, clopidogrel) may need adjustment 3-5 days prior; communicate all medications to biopsy team and anesthesia
    • Pre-procedure Preparation: Arrange transportation if sedation or anesthesia planned; wear comfortable, loose-fitting clothing to allow access to biopsy site; remove makeup and nail polish; avoid perfumes and colognes; bring insurance information and identification
    • Allergies and Contrast Agents: Disclose any allergies to lidocaine, other local anesthetics, or iodine-based contrast agents; if imaging guidance (ultrasound or fluoroscopy) used, notify team of contrast allergies
    • Laboratory Testing: Baseline coagulation studies (PT/INR, PTT, platelet count) may be required to assess bleeding risk; results should be available prior to procedure date
    • Post-procedure Instructions: May resume normal diet and activities as tolerated; keep biopsy site clean and dry; avoid strenuous activities for 24-48 hours; monitor for excessive bleeding, infection (fever, warmth, increased pain), or hematoma formation; take prescribed antibiotics as directed
    • Special Considerations: Pregnancy should be disclosed if applicable; diabetics should inform team of blood sugar management; patients with implanted devices (pacemakers, metal implants) may require imaging modification; immunocompromised patients may need additional precautions

How our test process works!

customers
customers