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Pilonidal sinus Biopsy

Biopsy
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Report in 240Hrs

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At Home

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No Fasting Required

Details

Biopsy of sinus tract tissue.

₹370₹529

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Pilonidal Sinus Biopsy - Comprehensive Medical Test Guide

  • Section 1: Why is it done?
    • Test Purpose: A pilonidal sinus biopsy involves obtaining tissue samples from a pilonidal sinus tract (an abnormal skin cavity, usually located in the sacrococcygeal region near the tailbone) for histopathological examination to rule out malignancy and confirm benign disease.
    • Primary Indications: Suspected malignancy within the sinus tract; recurrent infections unresponsive to treatment; atypical presentation or appearance of the lesion; persistent drainage with unusual characteristics; evaluation of chronic or complicated pilonidal disease; assessment of tissue before surgical intervention.
    • Timing and Circumstances: Performed during initial evaluation of suspicious lesions; when clinical presentation suggests malignancy; prior to definitive surgical treatment; during follow-up of complicated cases; when imaging findings are inconclusive; as part of diagnostic workup for recurrent or non-healing lesions.
  • Section 2: Normal Range
    • Normal/Negative Results: Benign squamous epithelium; evidence of chronic inflammation and folliculitis; presence of hair follicles within the tract; granulation tissue without malignant features; foreign body reaction (consistent with embedded hair); no dysplasia or malignant cells.
    • Abnormal/Positive Results: Presence of malignant cells; squamous cell carcinoma; evidence of dysplasia; adenocarcinoma; melanoma; other malignant neoplasms; atypical cellular changes; high-grade dysplasia.
    • Units of Measurement: Qualitative histopathological findings; tissue description; microscopic classification; presence/absence of malignancy (binary interpretation).
    • Interpretation Guide: Negative = Benign disease, no malignancy detected, supportive of pilonidal sinus diagnosis; Positive = Malignant transformation present, requires immediate oncologic intervention; Borderline/Uncertain = May require repeat sampling, additional immunohistochemistry, or specialist review.
  • Section 3: Interpretation
    • Benign Pilonidal Sinus (Most Common): Histology shows stratified squamous epithelium lining the sinus tract; chronic inflammatory infiltrate present; hair follicles and folliculitis evident; granulation tissue and fibrous tissue formation; foreign body reaction from embedded hair; no cellular atypia; indicates benign disease amenable to surgical excision alone.
    • Squamous Cell Carcinoma (SCC): Malignant transformation of pilonidal sinus epithelium; rare complication occurring in 0.1-1% of cases; typically associated with long-standing chronic disease; presents with rapid growth, bleeding, or non-healing lesion; requires wide surgical excision and consideration of chemotherapy/radiation; significantly worsens prognosis.
    • Dysplasia (Low-Grade or High-Grade): Precancerous changes indicating malignant potential; warrants close surveillance and possible repeat biopsy; may indicate need for more aggressive surgical approach; high-grade dysplasia requires urgent intervention and consideration of adjuvant therapy.
    • Other Malignancies: Adenocarcinoma (mucinous or other types); melanoma; basal cell carcinoma; other rare malignancies; each requires specific staging, grading, and treatment protocols; mandates multidisciplinary team approach and oncologic consultation.
    • Factors Affecting Interpretation: Sample quality and adequacy; location of biopsy (superficial vs. deep); duration of pilonidal disease (chronic disease increases malignancy risk); patient demographics and risk factors; presence of secondary infection; crush artifact or processing issues; need for immunohistochemistry confirmation.
    • Clinical Significance: Benign results allow conservative management and elective surgical planning; malignant findings necessitate urgent intervention and oncologic treatment; dysplastic findings require surveillance protocol; results directly impact treatment aggressiveness, follow-up schedule, and patient prognosis.
  • Section 4: Associated Organs
    • Primary Organ System Involved: Integumentary system (skin and subcutaneous tissue); specifically the sacrococcygeal region (tailbone area); hair follicle apparatus; dermis and epidermis; underlying fascia and muscle.
    • Associated Medical Conditions: Pilonidal sinus disease (benign); squamous cell carcinoma of skin; pilonidal disease with malignant transformation; chronic suppurative skin infection; recurrent abscess formation; sinus tract infection with systemic involvement.
    • Diseases This Test Helps Diagnose: Malignant transformation of pilonidal sinus; squamous cell carcinoma; adenocarcinoma of pilonidal origin; melanoma in sacrococcygeal region; precancerous dysplasia; secondary malignancy; infection with unusual organisms; atypical inflammatory conditions.
    • Potential Complications of Abnormal Results: Rapid tumor progression if untreated; metastatic spread to regional lymph nodes (inguinal, iliac); distant metastasis to lungs, liver, or bone; invasion of underlying gluteal muscles; extension to rectum or anal canal; sepsis from severe infection; chronic pain and disability; compromised wound healing post-treatment; recurrent disease with higher morbidity.
    • Functional Impacts: Pain affecting mobility and sitting tolerance; chronic drainage causing hygiene concerns; impact on quality of life and psychological well-being; potential need for extended surgical reconstruction; altered bowel or urinary function if complications develop.
  • Section 5: Follow-up Tests
    • If Benign Results Confirmed: Surgical excision planning; preoperative imaging if extensive disease suspected; wound care assessment; post-operative follow-up at 2-4 weeks; wound healing evaluation; surveillance for recurrence; no additional oncologic workup required.
    • If Malignancy Detected: Staging imaging: CT chest/abdomen/pelvis or MRI for local extension; PET-CT for metastatic disease; sentinel lymph node biopsy if indicated; inguinal lymph node imaging and possibly biopsy; staging laparoscopy in selected cases; oncology consultation; grading and immunohistochemistry studies; tumor biomarker analysis as appropriate.
    • If Dysplasia Identified: Repeat biopsy in 4-6 weeks to assess progression; immunohistochemistry studies; molecular testing for malignancy markers; more aggressive surgical excision with wider margins; close clinical surveillance every 3-6 months; consideration of imaging if high-grade dysplasia present.
    • Additional Investigative Tests: MRI sacrococcygeal region for extent of disease; ultrasound to assess tract complexity; culture and sensitivity if infection present; Human Papillomavirus (HPV) testing if SCC suspected; p53 immunostaining for dysplasia assessment; Ki-67 proliferation index; flow cytometry in certain cases.
    • Monitoring Frequency: Benign disease: Follow-up 2-4 weeks post-operatively, then as clinically indicated; Dysplasia: Every 3-6 months for first 2 years, then annually; Malignancy: Every 1-3 months first year, every 3-6 months second year, then annually; Include physical examination and imaging as per oncologic protocol.
    • Complementary Diagnostic Tests: Clinical examination (serial photographs); imaging (ultrasound, MRI, CT); blood work (complete blood count, metabolic panel); tumor markers if malignancy detected; genetic testing if familial syndrome suspected; proctoscopy or sigmoidoscopy if rectal involvement possible.
  • Section 6: Fasting Required?
    • Fasting Requirement: NO - Fasting is NOT required for pilonidal sinus biopsy.
    • Pre-Procedure Preparation: Routine hygiene: Shower or bathe the day of procedure; thorough cleansing of sacrococcygeal region with soap and water; dry thoroughly; wear clean clothing; avoid deodorants or topical products in the area; arrive with full bladder if procedural anesthesia planned; normal meals and hydration permitted.
    • Medications - No Specific Restrictions: Continue regular medications unless otherwise instructed; anticoagulants (warfarin, dabigatran): notify provider; antiplatelet agents (aspirin, clopidogrel): discuss continuation; diabetic medications: continue as usual; blood pressure medications: continue as normal; if allergic to lidocaine or other local anesthetics, inform provider in advance.
    • Anesthesia Considerations: Local anesthesia typically used - minimal fasting needed; if general or regional anesthesia planned, follow NPO (nothing by mouth) instructions provided (usually 6-8 hours); if conscious sedation anticipated, fast 4-6 hours and arrange transportation home.
    • Patient Positioning & Comfort: Patient positioned prone or in lateral position; relaxed positioning essential; cushioning provided for comfort; procedure room temperature controlled; communication with provider encouraged.
    • Post-Procedure Instructions: Eat and drink normally after procedure if local anesthesia used; if sedation given, wait 30-60 minutes before eating; avoid strenuous activity for 24-48 hours; keep biopsy site clean and dry; use prescribed dressings; avoid sitting directly on the area if possible; take pain medications as needed; contact provider if excessive bleeding, fever, or signs of infection develop.
    • Specimen Handling: Multiple tissue samples obtained (typically 3-4 samples); specimens placed in formalin fixative; labeled with patient identifiers; sent to pathology laboratory for processing; results typically available in 5-10 business days; urgent processing available if clinically indicated.

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