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Splenectomy Biopsy

Biopsy
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Report in 240Hrs

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No Fasting Required

Details

Histology of spleen.

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Splenectomy Biopsy - Comprehensive Medical Test Information Guide

  • Why is it done?
    • Test Description: Splenectomy biopsy is a surgical procedure involving removal of the spleen (splenectomy) followed by comprehensive histopathological examination of the splenic tissue. The procedure provides direct tissue analysis to identify cellular abnormalities, infectious agents, malignancies, or structural pathology.
    • Primary Indications: Diagnosis of unexplained splenomegaly; diagnosis of lymphomas and leukemias; identification of infectious diseases (tuberculosis, fungal infections, parasitic infections); diagnosis of splenic infarction or rupture; evaluation of hematologic disorders; detection of storage diseases; assessment of infiltrative diseases; determination of splenic metastases; evaluation of immune thrombocytopenia (ITP) and autoimmune hemolytic anemia when other diagnostic methods are inconclusive.
    • Typical Timing/Circumstances: Performed when imaging studies (ultrasound, CT, MRI) show splenic abnormalities; when diagnostic aspiration cytology is non-diagnostic or unavailable; during emergency surgery for splenic trauma; when therapeutic splenectomy is indicated and tissue diagnosis is required; when other diagnostic modalities have failed to establish diagnosis; as part of staging procedures for malignancies.
  • Normal Range
    • Normal Findings: Normal splenic tissue demonstrates intact capsule and trabecular architecture; normal red pulp with appropriate erythrocyte congestion; white pulp with normal lymphoid follicles and germinal centers; absence of malignant cells; no significant fibrosis or necrosis; normal vasculature without infarction; absence of inflammatory infiltrates; absence of microorganisms; normal iron deposition in macrophages.
    • Result Interpretation Scale: Negative/Normal = Benign tissue without significant pathology; Borderline/Reactive = Mild hyperplasia or reactive changes; Abnormal = Confirmed pathological findings requiring clinical correlation and treatment planning.
    • Units of Measurement: Histopathological assessment (qualitative analysis); descriptive morphological findings; immunohistochemical staining percentages (where applicable); semi-quantitative scoring for inflammation and fibrosis (0-3+ scale); organism burden if infectious agents present.
    • Normal vs Abnormal Significance: Normal results indicate benign splenic tissue without malignancy, infection, or significant structural abnormality, though therapeutic splenectomy may still be clinically beneficial. Abnormal results indicate specific pathology requiring targeted treatment, potentially including chemotherapy, antimicrobial therapy, or additional surgical intervention depending on findings.
  • Interpretation
    • Lymphoid Neoplasms: Detection of lymphoma cells with specific immunophenotyping (B-cell vs T-cell lineage); identification of involvement pattern (nodal vs diffuse); grade assessment (low vs high grade); subtype classification (DLBCL, follicular, Hodgkin, etc.); determination of proliferation rate; identification of genetic alterations when present.
    • Infectious Etiologies: Bacterial organisms (Mycobacterium tuberculosis, Bartonella, Brucella); fungal agents (histoplasmosis, blastomycosis, cryptococcosis); parasitic infections (toxoplasmosis, schistosomiasis, malaria); viral inclusions; granuloma formation indicating mycobacterial or fungal infection; culture and stain results confirming specific organisms.
    • Reactive and Inflammatory Changes: Follicular hyperplasia indicating immune activation; reactive histiocytosis; increased red pulp cellularity; hemophagocytosis in hemophagocytic syndrome; granulomatous inflammation; plasma cell infiltration; severity grading to determine clinical significance.
    • Factors Affecting Interpretation: Specimen quality and adequate sampling; fixation and processing time; patient's immune status (immunocompromised vs immunocompetent); recent infections or vaccinations; prior chemotherapy or radiation; medications affecting tissue appearance; degree of tissue autolysis if surgical delay occurred; tissue site examined (multiple areas sampled for heterogeneous lesions).
    • Clinical Significance of Result Patterns: Focal lesions may indicate primary splenic pathology or metastatic disease; diffuse infiltration suggests systemic disease; granulomatous pattern suggests infection or sarcoidosis; hemophagocytosis indicates potentially life-threatening syndrome; normal tissue may support therapeutic splenectomy for ITP/AIHA; negative malignancy findings help stage lymphomas and guide treatment decisions.
  • Associated Organs
    • Primary Organ System: Lymphohematopoietic system; reticuloendothelial system; immune system (both humoral and cellular immunity); splenic filtration and hematopoietic functions.
    • Associated Medical Conditions: Hodgkin lymphoma and non-Hodgkin lymphoma; chronic lymphocytic leukemia; acute leukemias with splenic involvement; chronic myeloid leukemia; hairy cell leukemia; primary immune thrombocytopenia; autoimmune hemolytic anemia; Evans syndrome; splenic infarction; splenic rupture; splenic abscess; splenic tuberculosis; histoplasmosis; toxoplasmosis; sarcoidosis; Gaucher disease; sickle cell disease with splenic pathology.
    • Diseases Diagnosed or Monitored: Splenic lymphomas confirm diagnosis and determine subtype for treatment planning; infectious disease confirmation guides antimicrobial therapy; metastatic disease assessment impacts staging and prognostication; reactive processes differentiation from malignancy; evaluation of response to therapy in treated lymphomas.
    • Potential Complications from Abnormal Results: Aggressive lymphomas may show rapid clinical progression requiring urgent chemotherapy; disseminated infections indicate systemic disease requiring prolonged antimicrobial therapy; hemophagocytic syndrome indicates potentially fatal condition requiring immediate immunosuppressive treatment; splenic rupture leads to hemorrhagic shock and organ failure requiring emergency intervention; metastatic disease indicates advanced malignancy affecting overall prognosis and treatment approach; post-splenectomy overwhelming sepsis risk from encapsulated organisms (Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis) necessitating prophylactic vaccination and antibiotics.
  • Follow-up Tests
    • Additional Tests Based on Results: If lymphoma confirmed: PET-CT for staging and treatment planning; LDH and beta-2 microglobulin for prognostic assessment; genetic/molecular testing (FISH, gene expression profiling) for subtype refinement; bone marrow biopsy if not previously performed. If infection identified: Blood cultures and sensitivity testing; appropriate antimicrobial susceptibility studies; serology for specific organisms; imaging to assess dissemination; CSF analysis if CNS involvement suspected.
    • Further Investigation Needs: Oncology consultation for malignant findings; infectious disease consultation for unusual infections; hematology follow-up for hematologic disorders; immunology evaluation if immunodeficiency suspected; genetic counseling if hereditary conditions identified; tissue sent for flow cytometry if not performed; molecular studies for prognostic markers.
    • Monitoring Frequency: Lymphoma patients: Follow-up imaging every 3-6 months during treatment; post-treatment surveillance imaging 6-12 months; routine clinical evaluation and laboratory studies at each visit. Treated infections: Repeat imaging at 2-4 weeks to assess response; follow-up labs to confirm microbiologic clearance; clinical reassessment for symptom resolution. ITP/AIHA post-splenectomy: Complete blood counts weekly for first month; monthly for 3 months; then every 3 months for long-term surveillance.
    • Complementary Tests: Complete blood count with differential; peripheral blood smear; coagulation studies; liver and kidney function tests; inflammatory markers (ESR, CRP); imaging studies (CT, MRI, PET-CT, ultrasound); flow cytometry; chromosomal analysis; molecular genetic testing; immunoglobulin levels; T-cell subset analysis; antibody titers post-vaccination.
  • Fasting Required?
    • Fasting Requirement: YES - Fasting is required. Splenectomy is a surgical procedure requiring general anesthesia.
    • Fasting Duration: NPO (nothing by mouth) for minimum 6-8 hours prior to surgery; typically overnight fasting recommended (patient should fast from midnight before morning surgery); clear liquids may be permitted up to 2-3 hours before procedure depending on anesthesiologist guidelines.
    • Special Instructions: Do not consume any food or beverages after midnight before scheduled surgery; do not chew gum or suck on candy; remove dentures, contacts, hearing aids, and prosthetics; remove all jewelry and body piercings; wear comfortable, loose-fitting clothing; arrange transportation as patient cannot drive after general anesthesia; bring all insurance documents and identification.
    • Medications to Avoid/Manage: Anticoagulants (warfarin, NOACs) - typically discontinued 3-5 days before surgery per cardiologist/hematologist recommendations; NSAIDs - avoid for 5-7 days before surgery; aspirin - typically discontinued 7-10 days prior; blood pressure medications - may be continued with small sip of water on morning of surgery per anesthesiologist; diabetes medications - adjust per surgeon and anesthesiologist guidance; herbal supplements - discontinue 2-3 weeks before surgery (ginkgo, ginger, garlic, vitamin E).
    • Other Preparation Requirements: Pre-operative labs: CBC, comprehensive metabolic panel, coagulation studies, blood type and cross-match, urinalysis, ECG, chest X-ray (depending on age and comorbidities); medical clearance from primary care physician and any relevant specialists; anesthesia pre-operative evaluation and assessment; signed informed consent after discussion of risks and benefits; discussion of post-operative prophylaxis (vaccinations for pneumococcal, meningococcal, Haemophilus influenzae infections); post-operative pain management plan; discussion of expected recovery timeline (3-4 weeks for return to normal activities).

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