DOCSLIB.ORG

Intestinal Lesions by Endoscopic Biopsy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Intestinal Lesions by Endoscopic Biopsy Kontham Praveen, Farida Begum, Kandukuri Mahesh Kumar. Study of histopathological types of gastro-intestinal lesions by endoscopic biopsy. IAIM, 2016; 3(11): 46-53. Original Research Article Study of histopathological types of gastro- intestinal lesions by endoscopic biopsy Kontham Praveen1, Farida Begum2, Kandukuri Mahesh Kumar3* 1Senior Resident, Department of Pathology, Government Medical College, Nizamabad, Telangana State, India 2Assistant Professor, Department of Pathology, Government Medical College, Nizamabad, Telangana State, India 3Assistant Professor, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana State, India *Corresponding author email: [email protected] International Archives of Integrated Medicine, Vol. 3, Issue 11, November, 2016. Copy right © 2016, IAIM, All Rights Reserved. Available online at http://iaimjournal.com/ ISSN: 2394-0026 (P) ISSN: 2394-0034 (O) Received on: 18-10-2016 Accepted on: 01-11-2016 Source of support: Nil Conflict of interest: None declared. How to cite this article: Kontham Praveen, Farida Begum, Kandukuri Mahesh Kumar. Study of histopathological types of gastro-intestinal lesions by endoscopic biopsy. IAIM, 2016; 3(11): 46-53. Abstract Introduction: Gastro Intestinal Tract (GIT) is an important site for wide variety of lesions which include congenital, inflammatory, neoplastic conditions. The invention of flexible fiber-optic endoscope is a very good achievement towards the diagnostic field. With the use of this facility direct vision of diseased mucosa and biopsy of mucosal lesions, therapeutic induction and photographic visualization of the lesions are made possible. Aim: Aim of this study was to know the incidence of Gastro intestinal lesions with reference to age, sex and site and to study the histopathological types of Gastro Intestinal lesions. Materials and methods: The present study included 180 GIT biopsies (gastro intestinal biopsies) between the period August 2013 to August 2015 .Clinical details and case histories were obtained from the patients presented to the gastroenterology department. Biopsies were obtained by the gastroenterologist with fiber optic forward viewing endoscope. Results: Among all the GIT biopsies, esophageal biopsies were 11 (6.11%), gastric biopsies were 31 (17.22%), gastro esophageal junction 4 (2.22%), and small Intestinal 67 (37.22%) and 67 (37.22%) was from large intestine. Conclusion: Endoscopy and subsequent biopsy for histopathology can detect early malignant lesions. In the absence of endoscopic screening, detection of these lesions may be missed. Such patients may present with advanced stage of disease in later life. In endoscopic biopsy only mucosa is seen, the level of invasion cannot be ascertained. Page 46 Kontham Praveen, Farida Begum, Kandukuri Mahesh Kumar. Study of histopathological types of gastro-intestinal lesions by endoscopic biopsy. IAIM, 2016; 3(11): 46-53. Key words Gastro Intestinal Tract Lesions, Endoscopy, Biopsy, Carcinoma, Polyp, Histopathology. Introduction transferring the tissue to the laboratory. After Gastro Intestinal Tract (GIT) is an important site usual time fixation of the biopsy specimen, it was for wide variety of lesions which include wrapped in a piece of filter paper after adding congenital, inflammatory, neoplastic conditions. eosin and processed accordingly .It is then In present era, gastroenterology is one of the unwrapped and embedded in paraffin with most important and expanding branch of mucosal surface uppermost .Four micron sections medicine. The invention of flexible fiber-optic were cut perpendicular to this surface and 3 to 4 endoscope is a very good achievement towards sections were taken on each slide .One slide was the diagnostic field. With the use of this facility stained with Hematoxylin and Eosin stain and direct vision of diseased mucosa and biopsy of studied. Apart from the routine Hematoxylin and mucosal lesions, therapeutic induction and Eosin stain, the sections were studied with the photographic visualization of the lesions are following special stains wherever it was made possible. The endoscopic biopsy in many necessary. instances has replaced, rather than being used as an adjunct procedure. Lesions of the GIT range Results from inflammatory lesions to carcinomas. The Among all the GIT biopsies, esophageal biopsies symptoms of GIT lesions include nausea, were 11 (6.11%), gastric biopsies were 31 vomiting, dyspepsia, pain abdomen, malaena etc. (17.22%), gastro esophageal junction 4 (2.22%), Thus, the following study is undertaken to study and small Intestinal 67 (37.22%) and 67 the histopathology of these lesions. These (37.22%) was from large intestine (Table - 1). biopsies will help a large group of patients who come or suffer with symptoms of abdominal Table - 1: site wise distribution of GIT lesions. diseases. After accurate diagnosis, treatment modalities can be applied. LESION TOTAL % Esophageal lesion 11 6.11 Aim Gastric lesion 31 17.22 Aim of this study was to know the incidence of Gastro esophageal junction 4 2.22 Gastro intestinal lesions with reference to age, Small intestine lesion 67 37.22 sex and site and to study the histopathological Large intestine lesion 67 37.22 types of Gastro Intestinal lesions. Maximum numbers of cases were seen in the 3th Materials and methods decade of life (23.88%) and only one case was found in 8th decade (1.21%) (Table - 2). Majority The present study included 180 GIT biopsies of the cases were seen in the age group of 21-40 (gastro intestinal biopsies) between the period years (42.21%). The oldest patient was 86 years August 2013 to August 2015 .Clinical details and and the youngest patient was 11 years. The sex case histories were obtained from the patients ratio was 1.2:1. Males were 99, females were presented to the gastroenterology department. 81. Biopsies were obtained by the gastroenterologist with fiber optic forward viewing endoscope. The lesions encountered were divided as Rapid fixation was done to prevent shrinkage by esophageal, Gastric lesions, gastresophageal placing the specimen in 10% neutral normal junction lesions, and Small intestine and large saline. Care was taken not to shake rigorously the intestine lesions. Commonest esophageal lesions bottle containing the specimen and also while were esophagitis and esophageal carcinoma Page 47 Kontham Praveen, Farida Begum, Kandukuri Mahesh Kumar. Study of histopathological types of gastro-intestinal lesions by endoscopic biopsy. IAIM, 2016; 3(11): 46-53. (2.8%) whereas commonest gastric lesion The commonest symptom overall was pain in encountered was chronic gastritis (10%). Other abdomen (31.7%) and diarrhoea 13.9%, esophageal lesions were esophagitis, Barret’s dysphagia 13.9%. The commonest sign and esophagus, ulcer, dysplasia, gastric carcinoma symptom in esophageal lesions were dysphagia (Table - 3). and loss of weight whereas pain in abdomen and diarrhoea was the commonest sign and symptom Table - 2: Age distribution of various lesions. in gastric lesion. Bleeding per rectum and constipation were the commonest signs in Age interval (Years) No. of cases % intestinal lesions. Dysphagia (100%) was the 11-20 8 4.4 commonest symptom of esophageal carcinoma. 21-30 33 18.33 Dysphagia 42.8%, Loss of weight 28.5%, 31-40 43 23.88 vomiting 14.2%, were the most common features 41-50 23 12.77 of Gastric Carcinoma.Bleeding per Rectum 51-60 30 16.66 (33.5%), Flatulence (33.3%), and pain abdomen 61-70 33 18.33 (33.3%) are associated with colon 71-80 9 5 Carcinoma.Occasionally cases of esophagitis also 81-90 1 0.55 showed patients suffering from hematemesis. TOTAL 180 100.0 Gastritis cases presented with pain in abdomen i.e. epigastric pain and vomiting with loss of Table - 3: Distribution of individual lesions. appetite.In patients with gastric polyp the most commonly encountered symptom was pain in Lesion Cases % abdomen. Esophageal lesions In this study, total malignancies reported were 17 Esophagitis 5 2.8 which included 5 cases of esophageal Barret’s esophagitis 1 0.5 malignancy; Gastric malignancy comprised 7 Esophageal carcinoma 5 2.8 cases, colon and rectum comprised 3 and 2 cases Gastric lesions respectively. The age wise and sex wise Chronic gastritis 18 10 distribution has been tabulated (Table - 4). Polyp 04 2.2 01 0.6 Ulcer Eighty percent (4 cases) of the total esophageal Dyspepsia 01 0.60 carcinoma (5) were squamous cell carcinoma Gastric carcinoma 07 3.8 were whereas adenocarcinoma were 20% (1 Gastresophageal junction 04 2.2 case). Histological typing with endoscopic Small intestinal lesions 67 findings is tabulated in Table - 5. Crohn’s disease 23 12.8 Inflammatory bowel disease 15 18.7 Gastric carcinoma was seen in 7 cases. All were Non specific colitis 21 11.6 adenocarcinomas .Endoscopically out of 7 cases, Hyperplasic polyp 8 4.4 4 cases showed ulcero-proliferative growth, 1 Large intestinal lesions 67 showed papillary folds in fundus and 2 were Chronic non specific 38 21.1 undifferentiated. Histological grading of the infection stomach carcinoma is tabulated in Table - 6. Inflammatory bowel disease 22 12.2 Colon cancer 3 1.7 The upper and lower esophagus were the Carcinoma rectum 2 1.1 commonest sites for esophageal carcinoma i.e. 4 Solitary rectal ulcer 2 1.1 out of 5 cases (80%) whereas antrum was the common site for gastric carcinoma, 4 cases out of 7 cases (57.14%). Page 48 Kontham Praveen, Farida Begum, Kandukuri Mahesh Kumar. Study of histopathological types of gastro-intestinal lesions by endoscopic biopsy. IAIM, 2016; 3(11): 46-53. Table - 4: Age distribution of malignancy. Age interval (Years) Esophagus cancer Gastric cancer Colon cancer Rectal cancer 21-30 1 1 0 1 31-40 1 1 0 0 41-50 2 1 0 0 51-60 1 2 1 0 61-70 0 2 2 1 71-80 0 0 0 0 TOTAL 5 7 3 2 Table - 5: Esophageal carcinoma-endoscopic and histopathlogical findings. Lesion Squamous cell carcinoma (%) Adenocarcinoma (%) Total cases Ulcerated 2 1 3 (60%) Proliferative 2 0 2 (40%) Total 4 (80%) 1 (20%) 5 (100%) Table - 6: Histological grading of stomach Endoscopically and clinically 8 lesions of the carcinoma.
Load more

Recommended publications
  • Study Guide Medical Terminology by Thea Liza Batan About the Author
    Study Guide Medical Terminology By Thea Liza Batan About the Author Thea Liza Batan earned a Master of Science in Nursing Administration in 2007 from Xavier University in Cincinnati, Ohio. She has worked as a staff nurse, nurse instructor, and level department head. She currently works as a simulation coordinator and a free- lance writer specializing in nursing and healthcare. All terms mentioned in this text that are known to be trademarks or service marks have been appropriately capitalized. Use of a term in this text shouldn’t be regarded as affecting the validity of any trademark or service mark. Copyright © 2017 by Penn Foster, Inc. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner. Requests for permission to make copies of any part of the work should be mailed to Copyright Permissions, Penn Foster, 925 Oak Street, Scranton, Pennsylvania 18515. Printed in the United States of America CONTENTS INSTRUCTIONS 1 READING ASSIGNMENTS 3 LESSON 1: THE FUNDAMENTALS OF MEDICAL TERMINOLOGY 5 LESSON 2: DIAGNOSIS, INTERVENTION, AND HUMAN BODY TERMS 28 LESSON 3: MUSCULOSKELETAL, CIRCULATORY, AND RESPIRATORY SYSTEM TERMS 44 LESSON 4: DIGESTIVE, URINARY, AND REPRODUCTIVE SYSTEM TERMS 69 LESSON 5: INTEGUMENTARY, NERVOUS, AND ENDOCRINE S YSTEM TERMS 96 SELF-CHECK ANSWERS 134 © PENN FOSTER, INC. 2017 MEDICAL TERMINOLOGY PAGE III Contents INSTRUCTIONS INTRODUCTION Welcome to your course on medical terminology. You’re taking this course because you’re most likely interested in pursuing a health and science career, which entails ­proficiency­in­communicating­with­healthcare­professionals­such­as­physicians,­nurses,­ or dentists.
    [Show full text]
  • Oncology 101 Dictionary
    ONCOLOGY 101 DICTIONARY ACUTE: Symptoms or signs that begin and worsen quickly; not chronic. Example: James experienced acute vomiting after receiving his cancer treatments. ADENOCARCINOMA: Cancer that begins in glandular (secretory) cells. Glandular cells are found in tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices, or other fluids. Most cancers of the breast, pancreas, lung, prostate, and colon are adenocarcinomas. Example: The vast majority of rectal cancers are adenocarcinomas. ADENOMA: A tumor that is not cancer. It starts in gland-like cells of the epithelial tissue (thin layer of tissue that covers organs, glands, and other structures within the body). Example: Liver adenomas are rare but can be a cause of abdominal pain. ADJUVANT: Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy. Example: The decision to use adjuvant therapy often depends on cancer staging at diagnosis and risk factors of recurrence. BENIGN: Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body. Also called nonmalignant. Example: Mary was relieved when her doctor said the mole on her skin was benign and did not require any further intervention. BIOMARKER TESTING: A group of tests that may be ordered to look for genetic alterations for which there are specific therapies available. The test results may identify certain cancer cells that can be treated with targeted therapies. May also be referred to as genetic testing, molecular testing, molecular profiling, or mutation testing.
    [Show full text]
  • Inspection Examination of the Ureter and Biopsy Procedure Specific
    PATIENT INFORMATION Inspection/examination of the ureter & biopsy : procedure-specific information What is the evidence base for this information? This leaflet includes advice from consensus panels, the British Association of Urological Surgeons, the Department of Health and evidence-based sources; it is, therefore, a reflection of best practice in the UK. It is intended to supplement any advice you may already have been given by your GP or other healthcare professionals. Alternative treatments are outlined below and can be discussed in more detail with your Urologist or Specialist Nurse. What does the procedure involve? Examination of the ureter and kidney ± biopsy, with possible placement of a plastic tube or stent. This procedure usually includes cystoscopy and x-ray screening What are the alternatives to this procedure? Open surgery, other X-ray investigations or further observation Source: Urology Reference No: 5611-1 Issue date: 27.06.2014 Review date: 27.06.2016 Page 1 of 5 What should I expect before the procedure? You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry- mouthed and pleasantly sleepy.
    [Show full text]
  • Gastroesophageal Reflux Disease (GERD)
    Guidelines for Clinical Care Quality Department Ambulatory GERD Gastroesophageal Reflux Disease (GERD) Guideline Team Team Leader Patient population: Adults Joel J Heidelbaugh, MD Objective: To implement a cost-effective and evidence-based strategy for the diagnosis and Family Medicine treatment of gastroesophageal reflux disease (GERD). Team Members Key Points: R Van Harrison, PhD Diagnosis Learning Health Sciences Mark A McQuillan, MD History. If classic symptoms of heartburn and acid regurgitation dominate a patient’s history, then General Medicine they can help establish the diagnosis of GERD with sufficiently high specificity, although sensitivity Timothy T Nostrant, MD remains low compared to 24-hour pH monitoring. The presence of atypical symptoms (Table 1), Gastroenterology although common, cannot sufficiently support the clinical diagnosis of GERD [B*]. Testing. No gold standard exists for the diagnosis of GERD [A*]. Although 24-hour pH monitoring Initial Release is accepted as the standard with a sensitivity of 85% and specificity of 95%, false positives and false March 2002 negatives still exist [II B*]. Endoscopy lacks sensitivity in determining pathologic reflux but can Most Recent Major Update identify complications (eg, strictures, erosive esophagitis, Barrett’s esophagus) [I A]. Barium May 2012 radiography has limited usefulness in the diagnosis of GERD and is not recommended [III B*]. Content Reviewed Therapeutic trial. An empiric trial of anti-secretory therapy can identify patients with GERD who March 2018 lack alarm or warning symptoms (Table 2) [I A*] and may be helpful in the evaluation of those with atypical manifestations of GERD, specifically non-cardiac chest pain [II B*]. Treatment Ambulatory Clinical Lifestyle modifications.
    [Show full text]
  • Biopsy and Cytology
    BIOPSY AND CYTOLOGY Biopsy • Definition • Biopsy is the removal of a sample of living tissue for laboratory examination. • Rationale • It is a dentist’s obligation to make a diagnosis, or see that a diagnosis is made, of any pathological lesion in the mouth. • Some lesions can be diagnosed clinically, and biopsy is not required e.g. recurrent aphthous ulceration, Herpes simplex lesions. • Many lesions cannot be positively diagnosed clinically and should be biopsied – or in some cases smeared for cytopathologic examination. • Pitfalls of relying on a strictly clinical diagnosis are numerous: • A loose tooth may be due to a malignancy, not to advance periodontal disease. • What appears to be a dentigerous cyst clinically e.g. may be an odontogenic tumor. • Harmless looking white patches may be malignant or premalignant. Red patches are even more important. • It has been said that “any tissue which has been removed surgically is worth examining microscopically” • Yet dentists in general do not follow this rule. • However, there are some tissues e.g. gingivectomies, where every specimen need not be submitted. • While cancer is one disease in which biopsy is important, there are many other lesions in which this procedure is useful. • It is a sensitive diagnostic tool. CDE (Oral Pathology and Oral Medicine) 1 BIOPSY AND CYTOLOGY • Methods of Biopsy • Excisional – entire lesion is removed, along with a margin of normal tissue. • Incisional – representative portion of the lesion is removed, along with a margin of normal tissue. • Electrocautery – tends to damage tissue and make interpretation difficult. • Punch • Needle and aspiration • Curettage – intraosseous • Exfoliative cytology. • The Oral Biopsy – Avoidable Pitfalls.
    [Show full text]
  • Biopsy Features in Inflammatory Bowel Disease Gut: First Published As 10.1136/Gut.35.7.961 on 1 July 1994
    Gut 1994; 35: 961-968 961 Observer variation and discriminatory value of biopsy features in inflammatory bowel disease Gut: first published as 10.1136/gut.35.7.961 on 1 July 1994. Downloaded from A Theodossi, D J Spiegelhalter, J Jass, J Firth, M Dixon, M Leader, D A Levison, R Lindley, I Filipe, A Price, N A Shepherd, S Thomas, H Thompson Abstract macroscopic and biopsy material taken from If skilled histopathologists disagree over patients with inflammatory bowel disease. the same biopsy specimen, at least one They reported the percentage agreement, but must have an incorrect interpretation. did not take into account the proportion of Thus, disagreement is associated with, observed agreement due to chance alone. although not the cause of, diagnostic Surawicz and Belic6 and Allison et al 7 con- error. The present study aimed to sidered the value of features in discriminating determine the magnitude of variation acute self limited colitis from idiopathic among 10 observers with a special interest inflammatory bowel disease, and reported both in gastrointestinal histopathology. They definitions and simple percentage agreement independently interpreted the same on selected features. biopsy specimens for morphological We believe that histopathology provides an features which may discriminate between important contribution to the diagnosis of patients with Crohn's disease and ulcera- inflammatory bowel disease. The aim of the tive colitis and normal subjects. Thirty of present study therefore was to determine the 41 features had agreement measures reliability of the information obtained from significantly better than expected by colorectal mucosal biopsy specimens by chance (p<005). The range of agreement assessing the magnitude of variation among 10 in the 45 observer pairs over the final histopathologists with a special interest in diagnosis was 65-76%.
    [Show full text]
  • AASLD Position Paper : Liver Biopsy
    AASLD POSITION PAPER Liver Biopsy Don C. Rockey,1 Stephen H. Caldwell,2 Zachary D. Goodman,3 Rendon C. Nelson,4 and Alastair D. Smith5 This position paper has been approved by the AASLD and College of Cardiology and the American Heart Associa- represents the position of the association. tion Practice Guidelines3).4 Introduction Preamble Histological assessment of the liver, and thus, liver bi- These recommendations provide a data-supported ap- opsy, is a cornerstone in the evaluation and management proach. They are based on the following: (1) formal re- of patients with liver disease and has long been considered view and analysis of the recently published world to be an integral component of the clinician’s diagnostic literature on the topic; (2) American College of Physi- armamentarium. Although sensitive and relatively accu- cians Manual for Assessing Health Practices and De- rate blood tests used to detect and diagnose liver disease signing Practice Guidelines1; (3) guideline policies, have now become widely available, it is likely that liver including the AASLD Policy on the Development and biopsy will remain a valuable diagnostic tool. Although Use of Practice Guidelines and the American Gastro- histological evaluation of the liver has become important enterological Association Policy Statement on Guide- in assessing prognosis and in tailoring treatment, nonin- lines2; and (4) the experience of the authors in the vasive techniques (i.e., imaging, blood tests) may replace specified topic. use of liver histology in this setting, particularly with re- Intended for use by physicians, these recommenda- gard to assessment of the severity of liver fibrosis.5,6 Sev- tions suggest preferred approaches to the diagnostic, ther- eral techniques may be used to obtain liver tissue; a table apeutic, and preventive aspects of care.
    [Show full text]
  • Needle Biopsy and Radical Prostatectomy Specimens David J Grignon
    Modern Pathology (2018) 31, S96–S109 S96 © 2018 USCAP, Inc All rights reserved 0893-3952/18 $32.00 Prostate cancer reporting and staging: needle biopsy and radical prostatectomy specimens David J Grignon Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, IUH Pathology Laboratory, Indianapolis, IN, USA Prostatic adenocarcinoma remains the most common cancer affecting men. A substantial majority of patients have the diagnosis made on thin needle biopsies, most often in the absence of a palpable abnormality. Treatment choices ranging from surveillance to radical prostatectomy or radiation therapy are largely driven by the pathologic findings in the biopsy specimen. The first part of this review focuses on important morphologic parameters in needle biopsy specimens that are not covered in the accompanying articles. This includes tumor quantification as well as other parameters such a extraprostatic extension, seminal vesicle invasion, perineural invasion, and lymphovascular invasion. For those men who undergo radical prostatectomy, pathologic stage and other parameters are critical in prognostication and in determining the appropriateness of adjuvant therapy. Staging parameters, including extraprostatic extension, seminal vesicle invasion, and lymph node status are discussed here. Surgical margin status is also an important parameter and definitions and reporting of this feature are detailed. Throughout the article the current reporting guidelines published by the College of American Pathologists and the International Collaboration on Cancer Reporting are highlighted. Modern Pathology (2018) 31, S96–S109; doi:10.1038/modpathol.2017.167 The morphologic aspects of prostatic adenocarcinoma hormonal therapy.4,5 For needle biopsy specimens the have a critical role in the management and prognos- data described below are largely based on standard tication of patients with prostatic adenocarcinoma.
    [Show full text]
  • SCREENING OR BIOPSY PROCEDURES Combined Items Length: 4 First Digit: Item Name: Biopsy Procedure Item Length: (1) Second Digit
    Stage of Disease at Diagnosis SCREENING OR BIOPSY PROCEDURES Combined Items Length: 4 First digit: Item Name: Biopsy procedure Item Length: (1) Second digit: Item Name: Guidance Item Length: (1) Third digit: Breast: Palpability of primary Prostate: Approach for biopsy of primary (1) Item Length: (1) Fourth digit: Breast: First detected by Prostate: Biopsy of other than primary Item Length: (1) Data Type: Numeric Allowable Values: Site Specific Required Data Set “Screening or Biopsy Procedures” are biopsies that do not grossly remove the primary tumor and/or surgical margins were macroscopically involved. Screening and biopsy procedures are collected on two sites, breast and prostate. If the primary tumor was grossly removed during the biopsy procedure, code all of the screening and biopsy items 0 (not done, not a separate procedure). The biopsy would be coded as cancer-directed surgery. If the primary site is other than breast or prostate, code all data items 0. BREAST Biopsy Procedure (Breast Only) 0 Not done, not a separate procedure 1 Biopsy, NOS 2 Fine needle aspiration (cytology) 3 Core biopsy (histology) 5 Excision of major duct (if procedure removes all gross primary tumor, code as cancer-directed surgery) 9 Unknown if biopsy performed; death certificate only 178 / Registry Operations and Data Standards Revised 8/00 CODE DEFINITION (BIOPSY PROCEDURE) 0 No screening or biopsy procedures were done. Biopsy was performed, but was a part of first course surgery (e.g, excisional biopsy). Not a breast or prostate primary 1 A biopsy was done, but the type is unknown. 2 A fine needle aspiration was done and the results were interpreted by cytology.
    [Show full text]
  • Icd-9-Cm (2010)
    ICD-9-CM (2010) PROCEDURE CODE LONG DESCRIPTION SHORT DESCRIPTION 0001 Therapeutic ultrasound of vessels of head and neck Ther ult head & neck ves 0002 Therapeutic ultrasound of heart Ther ultrasound of heart 0003 Therapeutic ultrasound of peripheral vascular vessels Ther ult peripheral ves 0009 Other therapeutic ultrasound Other therapeutic ultsnd 0010 Implantation of chemotherapeutic agent Implant chemothera agent 0011 Infusion of drotrecogin alfa (activated) Infus drotrecogin alfa 0012 Administration of inhaled nitric oxide Adm inhal nitric oxide 0013 Injection or infusion of nesiritide Inject/infus nesiritide 0014 Injection or infusion of oxazolidinone class of antibiotics Injection oxazolidinone 0015 High-dose infusion interleukin-2 [IL-2] High-dose infusion IL-2 0016 Pressurized treatment of venous bypass graft [conduit] with pharmaceutical substance Pressurized treat graft 0017 Infusion of vasopressor agent Infusion of vasopressor 0018 Infusion of immunosuppressive antibody therapy Infus immunosup antibody 0019 Disruption of blood brain barrier via infusion [BBBD] BBBD via infusion 0021 Intravascular imaging of extracranial cerebral vessels IVUS extracran cereb ves 0022 Intravascular imaging of intrathoracic vessels IVUS intrathoracic ves 0023 Intravascular imaging of peripheral vessels IVUS peripheral vessels 0024 Intravascular imaging of coronary vessels IVUS coronary vessels 0025 Intravascular imaging of renal vessels IVUS renal vessels 0028 Intravascular imaging, other specified vessel(s) Intravascul imaging NEC 0029 Intravascular
    [Show full text]
  • Lung Cancer Biopsies
    UNDERSTANDING LUNG CANCER BIOPSIES 1-800-298-2436 LungCancerAlliance.org 1 1 CONTENTS What is a Biopsy? ..............................................................................................................3 Non-Surgical Biopsies .....................................................................................................4 Surgical Biopsies ...............................................................................................................6 Risks of Having a Biopsy .................................................................................................7 Questions to Ask ...............................................................................................................8 For More Information ......................................................................................................9 About Lung Cancer Alliance ...................................................................................... 10 2 WHAT IS A BIOPSY? WHAT DOES A BIOPSY TELL US? A biopsy is a procedure to determine if a suspicious area is cancer. In a biopsy, tissue or fluid is removed from the body and examined under a microscope by a doctor called a pathologist. If the biopsy indicates there is cancer present, it also identifies the type of cancer. If it is lung cancer, the biopsy should show the type of lung cancer, either non- small cell or small cell. There are a number of ways that tissue or fluid can be removed for biopsy. The type of procedure is determined by what is being studied, where it is located in
    [Show full text]
  • Weekend RUSH Biopsy Scanning Protocol
    01/2020 Weekend RUSH Biopsy Protocol Background: While many cases are labelled “RUSH” in Beaker, not all are clinically rush cases, and may have just received that label due to protocols (ie most biopsy specimens). These protocols help ensure that cases are processed as swiftly, efficiently and accurately as possible by all anatomic pathology staff who encounter the case. During the week, in most cases this distinction is not as significant. However, for cases accessioned on Fridays, it is important to make the distinction between cases that are truly rush and those that are not. True rush cases need to be looked at by a pathologist the following day (Saturday), and a preliminary result may need to be communicated to the clinicians if indicated. Cases that are not truly rush do not need to be looked at over the weekend. True rush cases can be scanned by histology Saturday morning, and available for digital review. How do I tell if a case is a true rush? Is the case flagged as rush? Check the protocol assigned to the case. o Some protocols are commonly associated with a true rush status (ie: Kidney, Biopsy) o Some protocols are rarely associated with a true rush status: (ie: Breast, Core Biopsy) Check the clinical context. o In broad terms, some clinical questions are a rush and some are not, even if the tissue that was collected may seem like it (i.e. a biopsy specimen) o Examples: . Tumor diagnoses generally are not a rush I.e.: biopsies of the breast, cervix, liver for tumor, lymph nodes, etc One exception could be if the patient in the hospital, requiring diagnosis for immediate treatment.
    [Show full text]