Histological examination of biopsy material is an obligatory stage of a comprehensive examination if a neoplasm is found in a patient. Such a study will help to establish its nature: benign or malignant, in order to draw up a complete treatment regimen based on the information received.
The technique involves microscopic examination of a tissue sample collected from the patient’s problem area. Biological material is obtained for conducting a control section by classical biopsy, or during surgical intervention. The appointment of the procedure is carried out even when the person turned to the doctor for the excision of a standard papilloma.
Why this is necessary
Taking material for testing is necessary to solve several problems. Often, the method is resorted to in order to confirm or refute a previously established preliminary diagnosis. But this is not the only case when histology is indispensable.
In all oncology centers, it is used to find out at what stage of development the neoplasm is. Also, monitoring of this kind is carried out on a regular basis in order to follow the course of the pathological process in dynamics. Without technology, it is not complete at the preliminary stage of planning an operative intervention to remove a previously found neoplasm. The results of the study act as a kind of compass during the operation.
Also, the test is needed for classical differential diagnosis. It aims to accurately separate two pathologies that are similar in all respects. Comparison at the microscopic level will be especially relevant for detected metastases.
The final popular reason for using the measure is to determine the structural damage that is formed in the tissues over the entire period of treatment.
The modern scheme of therapy in oncology clinics without fail provides for many aspects of complex recovery. These are radiation and chemotherapy. But not a single drug of an oncological spectrum of action will be prescribed without the results of a histological examination being received by the doctor.
Mythological analysis allows you to choose the optimal set of drugs and measures of auxiliary healing from the first visit. This means that a person does not have to take all the medicines for about a month to see later how well the body responded to disparate drug support. Histology will tell you which drugs will be most effective, even if the victim was not a victim of tumor processes. The approach is in high demand in thoracic and abdominal surgery.
It is also actively used by experts from the field:
- gastroenterology;
- gynecology;
- pulmonology;
- otorhinolaryngology.
Moreover, the information summary obtained in this way is equally widely used for the subsequent treatment of both men and women. We are talking about the restoration of the reproductive system, as well as the treatment of the cervix among the fairer sex and the return of testicular functionality among the powerful.
How does this happen
If the tumor was confirmed in the victim, but its features have not yet been fully understood, then he is prescribed to undergo an intravital histology. Moreover, for the laboratory assistant, it is practically all the same from which part of the body the biological material will be extracted, as long as it is the affected area and the surgeon can get enough damaged cells.
To implement the plan, several biopsy formats are involved, depending on the current capabilities of physicians and the needs of a particular consumer:
- excisional;
- puncture;
- carved from a remote organ;
- forceps;
- aspiration;
- curettage.
In most cases, physicians are limited to the first option, since it involves obtaining the right amount of tissue during excision, when a general operation is performed. No less often in medical practice there is a puncture version. It is characterized by a puncture of the pathological focus due to a needle, with which a piece of problematic tissue is removed.
The forceps offer is nothing more than the usual biting of the desired part of the pathological formation with special tweezers – hence the name that speaks for itself. A forceps solution is used for joint endoscopy, such as:
- esophagogastroduodenoscopy;
- colonoscopy;
- bronchoscopies.
If the cavity turned out to be a problem area, then one cannot do without suction with a syringe of the liquid formed in the hollow part or the secret produced by the gland.
The final variation is called curettage. It is resorted to if you have to scrape out a potential lesion from organs with cavities, or straight from cavities that were formed as a result of a malignant process.
How the biopsy will be collected, the doctor decides at the stage of preliminary discussion with his ward. To make the final decision, the individual characteristics of the subject’s body and the proposed location of the inflammation are taken into account.
Only an experienced doctor should conduct a control cut, since if the rules for taking the material are not followed, in the future there is a high probability of obtaining a result with large errors. In the best case, the collection will have to be repeated, and in the worst case scenario, the oncologist may not notice the problem at all.
Do not be afraid of situations when the attending specialist insists that the histology should be carried out by a pathologist. It is he who specializes in a given area of research. He is sometimes even invited to the operation itself, and not just to the counseling stage. A qualified pathologist will point out the exact place to collect tissue samples, and at the same time recommend the safest method of fixation, suggesting the exact volume of cells to be measured.
If a small lesion is found in the victim, then it is cut off entirely, and the healthy surrounding tissue is additionally covered in a size of about one centimeter. When the operation involves the removal of a benign neoplasm, then surgical intervention implies a radical measure. Doctors in such a scenario must take into account the possible aesthetic effect.
Sometimes it is not possible to remove the entire formation entirely. Then the volume of the neutralized sample should be as large as possible, and the tissues should be cut where the pathology is most clearly visible. Also, the doctor must always keep in mind the risks of trauma to the stomach or any other area under study. A real pro will try to make sure that the area of the healthy part of the organ remains as untouched as possible, and the actions performed do not change the structure of the sample itself.
If an electric knife is involved in the work, then the cut-off line should be at a distance of at least 2 millimeters to the main point of destruction. The collected material should be treated with care, avoiding touching with fingers or crushing with accompanying medical instruments. It is allowed to hold the sample only by the fabric strip of the fabric.
Another important stage of cell sampling is the correct documentation. The clinician is obliged not only to correctly label the biopsy, but at the same time to enter all the necessary information about the type of operation performed into the protocol, as well as fill out a description of the removed part of the organ.
The technician should ensure that the patient’s initials are spelled neatly along with the address. On the same document, a note is made regarding the localization of the pathology, the connection of the material obtained with others:
- bodies;
- bundles;
- muscles.
In order for the harvested tissues to successfully survive transport to the research department, the material is immersed in a fixative solution. It should also be borne in mind that in its original form the material cannot be stored for a long time due to the fact that it dries quickly, distorting the reliability of the clinical picture. The smallest samples, which very quickly lose accumulated moisture, were the first to be at risk.
Not everything is perfect if it turns out that the sample is too large. In order for formalin to pass inside, the medical staff must make small incisions. Here there is a risk of spoiling the workpiece due to the fact that an incorrectly made incision can significantly disrupt the original structure of the fibers, which will distort the effectiveness of the test.
Because of this, the pros never make through cuts, and also always limit themselves to one or two cuts. For the same reason, it is forbidden to divide the material in order to send it to several laboratories at the same time.
The explanation for this is the heterogeneity of tumors, which is why the cut from different places will be uneven in homogeneity. This can interfere with the correct choice of treatment tactics.
The results, depending on the type of tumor, are usually ready within five days to two weeks. The biggest wait is when sending a bone normality test.
Approximate Results
The final price of the examination will depend on the format of the tissue sent for examination. The high productivity of histology is explained by the fact that the morphology of the selected piece is examined in detail under a microscope. This means that the diagnostician can independently examine the biomaterial and see possible pathological changes without the help of ultrasound or computed tomography.
Before placing tissue under a microscope, the specialist will first stain it with a special chemical reagent. Such an auxiliary stage is aimed at better delimiting a healthy zone from anomalies.
The doctor, seeing the result during the increase in the size of the imaging, will be able to identify microscopic changes, and will also analyze the anatomical nature of the detected changes. An indicative verdict is issued when the collected information is interpreted in favor of the preliminary diagnoses. In this scenario, it is impossible to do without auxiliary differential diagnostics.
The final word remains with the results of the histology. Here, the doctor will definitely take into account the results of various examinations, as well as the medical history from the medical record, hereditary predisposition, and the patient’s current complaints.
Separately, it should be borne in mind that it is not always possible to take the sample that is necessary in all respects from the first run. Sometimes lab technicians have to leave a descriptive answer alone. This applies to situations where an insufficient amount of biological material has been extracted, or when there is a lack of related data regarding the nature of the suspected disease.
When the biological product was not enough, or the doctor for some reason managed to cut off more of the healthy part than the patient, the diagnostician puts a record of a false negative result in the conclusion column. When in the same place there is a mark of a false positive result, the decoding provides for the absence of clinical and laboratory data about the patient in the direction.
In both situations, everything will have to be redone. To avoid double work, physicians should immediately establish a productive collaboration with the pathologist.
It is equally important to monitor what happens with a histology appointment for diagnostic purposes. Then, in the conclusion, indicate the data from the microscopic description, and also prescribe the nosological conclusion. A special medical nomenclature is used as an encryption technique.
Only if the rules are followed at all stages of histology will it be possible to draw up an accurate clinical picture of the patient’s state of health. This will help him in a speedy recovery in an operative or alternative way.