Macroscopic examination, dissection, and preparation of tissue for non-microscopic analytical studies (eg, nucleic acid-based molecular studies); each tissue preparation (eg, a single lymph node)
CPT4 code
Name of the Procedure:
Macroscopic Examination, Dissection, and Preparation of Tissue for Non-Microscopic Analytical Studies (e.g., Nucleic Acid-Based Molecular Studies); Each Tissue Preparation (e.g., a Single Lymph Node)
Summary
This procedure involves the visual examination, surgical dissection, and preparation of tissue samples, such as a lymph node, for tests that do not require a microscope, typically molecular studies to analyze nucleic acids like DNA and RNA.
Purpose
This procedure is essential for diagnosing medical conditions at a molecular level, such as genetic disorders, infections, and cancers. The goal is to obtain a high-quality tissue sample suitable for detailed molecular analysis.
Indications
- Detection of genetic mutations or abnormalities
- Diagnosis of certain types of cancers
- Evaluation of infectious diseases at the molecular level
- Patients with unexplained symptoms that may have a genetic or molecular basis
Preparation
- Patients may need to fast for a specific period before the procedure.
- Medication adjustments, such as stopping anticoagulants, may be recommended to minimize bleeding risks.
- Pre-procedure diagnostic tests can include blood tests, imaging studies, and consultations.
Procedure Description
- Visual Inspection: The tissue is visually examined for abnormalities.
- Dissection: The tissue, like a lymph node, is carefully dissected using surgical tools.
- Preparation: The dissected tissue is then prepared for molecular studies. This may involve preserving it in a suitable medium or freezing it.
- Tools and equipment include scalpels, forceps, preservation solutions, and sometimes cryogenic storage systems.
- Anesthesia or sedation may be used depending on the tissue sample location and patient comfort requirements.
Duration
The procedure typically takes between 30 minutes to 1 hour, depending on the complexity of the dissection.
Setting
This procedure is generally performed in a hospital, surgical center, or specialized outpatient clinic.
Personnel
- Pathologist or trained laboratory technician
- Surgeon (if surgical retrieval of tissue is required)
- Nurse or other supporting healthcare professionals
Risks and Complications
- Common risks include minor bleeding and discomfort.
- Rare risks might include infection, significant bleeding, or complications from anesthesia.
- Management of complications involves appropriate wound care, antibiotic therapy, or further surgical intervention if necessary.
Benefits
- Accurate molecular diagnosis can lead to targeted treatments.
- Early detection and diagnosis of conditions can improve outcomes.
- Results from molecular studies are generally available within days to weeks.
Recovery
- Post-procedure care usually involves monitoring and wound care instructions.
- Recovery time is minimal, with most patients resuming normal activities within a day to a week.
- Follow-up appointments may be necessary to discuss test results and further treatment plans.
Alternatives
- Needle biopsy or fine-needle aspiration provides tissue samples with less invasive methods but may not yield as detailed molecular information.
- Traditional microscopic examination can identify general pathology but may not offer molecular insights.
- Each alternative has its pros and cons, with less invasive methods being quicker but potentially less informative.
Patient Experience
- Patients may feel slight discomfort or pressure at the sample site.
- Pain management includes local anesthetics or pain-relief medications.
- Overall, the procedure is well-tolerated, and discomfort is usually minimal and temporary.