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Tongue growth - Large Biopsy 3-6 cm

Biopsy
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Report in 288Hrs

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No Fasting Required

Details

Histology of tongue lesion.

₹666₹951

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Tongue Growth - Large Biopsy 3-6 cm

  • Why is it done?
    • Histopathological diagnosis of suspicious tongue lesions or growths ranging from 3-6 cm in size to determine malignancy, benign tumor characteristics, or other pathological conditions
    • Detection and classification of oral squamous cell carcinoma (OSCC), the most common malignancy of the tongue
    • Assessment of benign growths including hemangiomas, lymphangiomas, lipomas, or cysts affecting the tongue
    • Evaluation of dysplastic changes and grade of dysplasia to assess malignant transformation risk
    • Identification of infectious or inflammatory conditions such as lichen planus, erythroplakia, or oral candidiasis presenting as tongue growths
    • Establishment of tumor grading and staging information necessary for treatment planning and prognosis
    • Performed when lesions persist beyond 2-3 weeks despite conservative management or show clinical signs concerning for malignancy
  • Normal Range
    • Normal/Benign Findings: Absence of malignant cells; normal stratified squamous epithelium with intact architecture; normal underlying connective tissue; no dysplasia or atypia present
    • Benign Lesion Classification: Specific benign diagnoses such as fibroma, lipoma, hemangioma, mucocele, or inflammatory hyperplasia with clear histological features
    • No Dysplasia: Epithelium shows normal maturation pattern without cellular atypia, increased mitotic activity, or architectural disorganization
    • Negative for Malignancy: No evidence of invasive carcinoma, adenocarcinoma, sarcoma, or other malignant processes
    • Units of Measurement: Specimen size 3-6 cm; histological grading using WHO classification; microscopic description of cellular morphology and tissue architecture
  • Interpretation
    • Squamous Cell Carcinoma (SCC): Presence of invasive nests of malignant epithelial cells with high nuclear-to-cytoplasmic ratio, abnormal mitoses, and tissue invasion; graded as Well-Differentiated (G1), Moderately-Differentiated (G2), or Poorly-Differentiated (G3); indicates malignancy requiring immediate treatment
    • Mild Dysplasia: Dysplastic changes limited to lower third of epithelium with increased mitotic activity and nuclear enlargement; indicates increased risk of malignant transformation; requires close follow-up and possible repeat biopsy
    • Moderate Dysplasia: Dysplastic changes extending to middle third of epithelium with increased cellular atypia and abnormal keratinization; higher malignant transformation risk; warrants close surveillance and possible surgical excision
    • Severe Dysplasia: Dysplastic changes involving more than two-thirds of epithelial thickness with significant cytologic atypia and loss of maturation; high risk for carcinoma development; typically requires surgical excision with wide margins
    • Carcinoma In Situ (CIS): Full-thickness dysplasia without invasion of underlying stroma; represents malignancy confined to epithelium; high risk for progression to invasive disease; requires aggressive surgical management
    • Adenocarcinoma: Malignant glandular or mucinous differentiation; may arise from salivary gland tissue within tongue; requires staging and multimodal treatment consideration
    • Sarcoma: Malignancy of mesenchymal origin including leiomyosarcoma, fibrosarcoma, or angiosarcoma; less common than carcinoma; requires specialized oncologic management
    • Factors Affecting Interpretation: Biopsy site sampling (central vs. peripheral), specimen adequacy, tissue fixation quality, staining technique, presence of inflammation or necrosis, and pathologist expertise in oral pathology
    • Clinical Significance: Results directly influence treatment planning, surgical margins, radiation therapy consideration, chemotherapy eligibility, and prognostic information; malignant findings necessitate urgent referral to head and neck oncology
  • Associated Organs
    • Primary Organ System: Oral mucosa and tongue musculature; integumentary system; parts of the digestive and respiratory systems
    • Associated Malignancies: Oral squamous cell carcinoma (OSCC) - most common; adenocarcinoma; verrucous carcinoma; undifferentiated carcinoma; sarcomas; lymphomas; melanoma
    • Benign Conditions Diagnosed: Fibromas and fibrous hyperplasias; lipomas; hemangiomas; lymphangiomas; mucoceles; cysts; inflammatory hyperplasias; traumatic lesions; geographic tongue; oral lichen planus; oral thrush/candidiasis
    • Dysplastic Conditions: Oral leukoplakia; erythroplakia; erythroleukoplakia; potentially malignant oral disorders (PMOD)
    • Risk Factors for Malignancy: Tobacco use (smoking and chewing); alcohol consumption; HPV infection; betel quid use; immunosuppression; previous head and neck cancer; poor oral hygiene; chronic irritation
    • Potential Complications of Malignancy: Local invasion affecting speech, swallowing, and breathing; lymph node metastasis; distant metastasis to lungs, liver, or bone; nerve involvement causing pain and dysfunction; infection; hemorrhage; compromised oral function and nutrition
    • Secondary Sites for Metastatic Disease: Cervical lymph nodes (most common); lungs; liver; bone; brain; skin; other oral tissues
  • Follow-up Tests
    • If Malignancy is Confirmed: MRI of head and neck for local staging and assessment of bone involvement; CT chest and abdomen for metastatic disease screening; PET-CT for comprehensive staging in high-grade tumors; immunohistochemistry for HPV testing and marker analysis
    • If Dysplasia is Present: Repeat biopsy at 6-12 weeks if margins are not clear; narrow-band imaging (NBI) for enhanced visualization of high-risk areas; clinical examination every 2-4 weeks; possible wide surgical excision with clear margins
    • If Benign Diagnosis: Clinical follow-up as appropriate to lesion type; possible surgical excision for cosmetic or functional concerns; reassurance and patient education; imaging only if symptomatic or growth occurs
    • Molecular and Genetic Testing: HPV/p16 immunohistochemistry to determine HPV status and prognosis; TP53 mutation analysis; EGFR testing; chromosomal alterations analysis for high-risk assessment
    • Surveillance and Monitoring: For malignancy: clinical examination every 1-3 months for first year, then quarterly; imaging every 6-12 months for 2-3 years; long-term surveillance for recurrence and second primary tumors
    • Complementary Tests: Fine needle aspiration (FNA) of suspicious lymph nodes; sentinel lymph node biopsy; baseline and post-treatment imaging; salivary flow rate testing if xerostomia is present; speech and swallowing evaluation
    • Surgical Pathology Review: Second opinion pathology review recommended for malignant diagnoses; review of margins and depth of invasion; assessment of perineural involvement
  • Fasting Required?
    • Fasting Status: No - Fasting is NOT required for this biopsy procedure
    • Pre-Procedure Preparation: Normal diet and hydration are permitted; patients should eat a light meal 1-2 hours before procedure if desired; good oral hygiene recommended (brush teeth but avoid vigorous rinsing)
    • Medications to Continue: Most routine medications may be continued; consult with clinician regarding specific medications; hypertension and cardiac medications should typically be continued
    • Medications to Avoid or Hold: Anticoagulants (warfarin, novel oral anticoagulants) - typically held 3-5 days before procedure; antiplatelet agents (aspirin, clopidogrel) - may need to hold 5-7 days depending on indication; NSAIDs - discontinue 1 week prior; herbal supplements with anticoagulant properties (ginger, ginkgo, garlic)
    • Additional Patient Instructions: Arrange transportation as procedure may be performed under local or conscious sedation; have responsible adult available for escort; wear comfortable, loose-fitting clothing; avoid alcohol for 24 hours before and after procedure; bring insurance card and identification; arrive 15-20 minutes early for registration
    • Post-Procedure Guidelines: Avoid eating for 2-3 hours until any anesthetic wears off; avoid hot foods/beverages for 24 hours; use ice packs to reduce swelling if needed; sleep with head elevated on 2-3 pillows; soft diet for 3-5 days; salt water rinses after 24 hours; avoid smoking and alcohol for 24-48 hours; take prescribed pain relief as directed
    • When to Contact Physician: Excessive bleeding that does not stop after 30 minutes of pressure; severe pain not relieved by medication; signs of infection (fever, increased swelling, pus); difficulty swallowing or breathing; numbness or weakness extending beyond expected area

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