Cervical biopsy and histology for dysplasia

Biopsy - this word scares many women, although the procedure itself is not dangerous. Only its result can be alarming, which is not always bad. A biopsy of the cervix in case of dysplasia is rather intended to exclude the risk of developing oncology and is one of the most common procedures in a comprehensive examination of women.

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Description of the procedure, how is a cervical biopsy performed for dysplasia?

• A biopsy is the removal of a small amount of epithelial tissue for examination.
• The procedure uses a very thin, specially designed needle with a cavity.
• The biopsy is performed during a colposcopic examination.
• The needle is inserted into the epithelial tissue after applying local anesthetic.
• The obtained biopsy (material) is sent to the laboratory for histological examination.
• The cellular material undergoes special processing (staining) and is examined under a microscope.
• Histology allows us to determine how dangerous cervical dysplasia is. The integrity of the cell structure, their morphology, and the number of tissue layers are assessed.
• The analysis allows us to determine the degree of damage to the epithelial tissue and clarify the preliminary diagnosis.

Biopsy is considered a highly informative method, the advantage of this procedure is that it is practically painless and is a minimally invasive examination method.

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Histology in cervical dysplasia

Histological studies are included in the diagnostic complex if the gynecologist has detected cervical dysplasia in a woman during the initial examination. It is histology that makes it possible to clarify the diagnosis, exclude or confirm cancer, carcinoma.

Let's take a closer look at what histology is:

• Histology is a method that studies the structure of tissue and identifies all deviations in the cellular structure.
• The basis of histology is the study of a section of tissue material, in this case, the epithelium of the cervix.
• The difference between histology and cytology is that a biopsy involves taking a deeper sample. Cytology involves scraping the surface of the cervical epithelium.
• Histology is performed during a colposcopic examination. Most often after the primary colposcopy, which determines the site of biopsy sampling.
• Histological examination is not considered complicated, with the exception of cases where epithelial damage is not clearly expressed and several biopsies from different sectors of the cervix are required.
• The obtained biopsy is examined using staining. Normally, epithelial tissue shows a brown color after staining. If there are pathological changes, the color of the tissue changes slightly or the material does not change color at all.
• When performing histology, the cervical tissue is damaged, to avoid infection or bleeding, the area can be sutured. But most often after a biopsy, a sterile hemostatic tampon is used, which copes well with the function of protecting and regenerating tissue.

What methods can be used for histology?

• Standard biopsy using a special hollow needle.
• Excision of a small area of tissue using a special medical electric knife (diathermoexcision).
• Laser excision.
• Excision using the latest modern instrument - a radio knife.
• Taking tissue with a scalpel.

Recommendations for histological tissue sampling

• This is the least traumatic and suitable method for young, nulliparous women.
• If the suspected altered area of the epithelium is small, sampling is carried out in a gentle manner in any sector of the cervix.
• For histology, preliminary diagnostic procedures are required - examination, cytology, colposcopy.

Normal histology results do not exclude the need for regular examinations and diagnostics. Visiting a gynecologist at least once a year should be the norm for every sensible woman, since cervical dysplasia can develop asymptomatically and without characteristic signs.

What are the criteria for determining the diagnosis after a biopsy?

• If there are disturbances in the structure of the epithelial layers.
• When the outer layer shows cell maturation activity (increase in ribosomes).
• If a decrease in the synthesis of specific glycogen is determined.
• Cell contact (desmos) is reduced.
• The cell nucleus is subject to pathological changes.
• Visible atypical mitochondria and other abnormal components of the cell's DNA.
• Changes in cell shape (cylindrical).

Degree of damage to epithelial cells:

1. The first are background changes, weakly expressed.
2. Moderate, second degree – atypical changes are expressed in half of all layers.
3. Severe atypia, third degree – changes affect two or more layers of the epithelium.

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