Uterus +Cervix+ 2 Falopian tube Biopsy - XL

Biopsy

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No Fasting Required

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Histology of reproductive organs.

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Uterus + Cervix + 2 Fallopian Tube Biopsy - XL

Why is it done?
- Diagnostic evaluation of abnormal uterine and cervical tissue to detect malignancies, including endometrial cancer, cervical cancer, and carcinoma of the fallopian tubes
- Investigation of persistent abnormal vaginal bleeding, postmenopausal bleeding, and unexplained pelvic pathology
- Evaluation of cervical lesions, polyps, or suspicious masses identified on imaging or clinical examination
- Assessment of chronic endometrial conditions, hyperplasia, and atypical glandular changes
- Investigation of suspected tubal pathology and assessment of fallopian tube integrity
- Performed typically during gynecological procedures such as hysteroscopy or laparoscopy under anesthesia
Normal Range
- Negative for malignancy: Absence of cancerous cells in all biopsied tissues (uterus, cervix, fallopian tubes)
- Normal endometrial tissue: Single layer of columnar epithelium with appropriate glandular and stromal elements consistent with proliferative or secretory phase
- Normal cervical tissue: Stratified squamous epithelium with intact surface and normal glandular structures; absence of dysplasia (CIN 0)
- Normal fallopian tube tissue: Intact mucosa with ciliated columnar epithelium and normal smooth muscle layer
- Benign findings: Non-neoplastic inflammatory changes, fibrosis, or benign polyps may be noted but are not indicative of malignancy
Interpretation
- Negative/Benign Results: Indicates absence of malignancy; may include normal tissue or benign pathology (inflammation, hyperplasia without atypia, fibroids, benign polyps)
- Endometrial Hyperplasia (with or without atypia): Simple hyperplasia carries lower malignant potential; complex hyperplasia with atypia (CAH) indicates significant risk for progression to endometrial cancer and requires immediate clinical intervention
- Cervical Intraepithelial Neoplasia (CIN): CIN 1 (mild dysplasia) may regress spontaneously; CIN 2-3 (moderate to severe dysplasia) requires treatment to prevent progression to invasive cancer
- Endometrial Cancer: Detection of adenocarcinoma or other malignant histotypes; grade and stage must be determined through additional imaging and pathological review to guide treatment planning
- Cervical Cancer: Positive findings confirm squamous cell carcinoma, adenocarcinoma, or other malignancies; requires staging and oncological management
- Fallopian Tube Pathology: Detection of tubal cancer, salpingitis, strictures, or other tubal abnormalities; tubal cancer is rare but carries significant clinical implications
- Factors Affecting Results: Menstrual cycle phase, hormonal therapy, infection, inflammation, technical factors in tissue collection, specimen fixation, and quality of histological examination may influence interpretation
Associated Organs
- Primary Organ System: Female reproductive system, including the uterus (corpus and endometrium), cervix, and fallopian tubes (bilateral sampling)
- Diseases Detected: Endometrial adenocarcinoma, cervical squamous cell carcinoma and adenocarcinoma, endometrial hyperplasia, cervical intraepithelial neoplasia (CIN), fallopian tube carcinoma, chronic endometritis, polyps, myomas, and uterine sarcomas
- Associated Medical Conditions: Postmenopausal bleeding, abnormal uterine bleeding (AUB), obesity, polycystic ovary syndrome (PCOS), metabolic syndrome, human papillomavirus (HPV) infection, nulliparity, infertility, tamoxifen use, and Lynch syndrome
- Potential Complications: Untreated endometrial and cervical malignancies may progress to advanced stages with metastatic disease; dysplastic lesions can transform to invasive cancer if not appropriately managed; fallopian tube cancer carries poor prognosis if diagnosed at advanced stage
Follow-up Tests
- Immunohistochemical (IHC) staining: To further characterize identified malignancies, assess molecular markers (estrogen/progesterone receptors, HER2, mismatch repair proteins), and guide targeted therapy options
- Molecular/Genetic Testing: HPV testing for cervical specimens, microsatellite instability (MSI) testing, and tumor suppressor gene analysis in malignancies to assess risk and inform prognosis
- Imaging Studies: Transvaginal or transabdominal ultrasound, CT scan, or MRI to assess extent of disease, evaluate for metastases, and guide staging
- Tumor markers: CA-125, HE4, CEA levels if malignancy is confirmed to establish baseline for monitoring treatment response
- Repeat biopsy or endometrial biopsy: May be needed if hyperplasia is identified to monitor progression or after treatment of dysplastic lesions
- Colposcopy: If cervical dysplasia is identified, colposcopic evaluation and potential excisional procedures (LEEP, cone biopsy) may be recommended
- Oncology consultation: Mandatory if malignancy is confirmed to discuss staging, surgical options, chemotherapy, radiation therapy, and immunotherapy
- Genetic counseling: Recommended if findings suggest hereditary cancer syndrome (Lynch syndrome) or familial ovarian/gynecologic cancer
Fasting Required?
- Fasting: Yes, fasting is typically required
- Duration: Minimum 6-8 hours of nothing by mouth (NPO) prior to procedure
- Special Instructions: Clear liquids (water, black coffee) may be permitted up to 2-4 hours before procedure, depending on facility protocol and anesthesia type
- Medications: Inform physician of all medications; anticoagulants (warfarin, DOACs), NSAIDs, and aspirin should be discontinued 5-7 days prior; pain management and hormone medications may continue with sips of water as per physician instructions
- Pre-procedure Requirements: Laboratory testing (CBC, type and cross for possible transfusion); imaging confirmation of target lesions; negative pregnancy test if applicable; signed informed consent; arranged transportation as procedure involves anesthesia
- Timing: Procedure ideally scheduled during early follicular phase (days 8-12 of menstrual cycle) when endometrium is thin; schedule outside of menstruation to optimize visualization and specimen quality

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