Endoscopic gastrointestinal biopsies: Difference between revisions

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{{Top
<noinclude>{{Top
|author1=[[User:Mikael Häggström|Mikael Häggström]]
|author1=[[User:Mikael Häggström|Mikael Häggström]]
|author2=
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{{Endoscopic biopsies}}
{{Endoscopic biopsies}}
{{Comprehensiveness}}
{{Comprehensiveness}}
{{Fixation - standard}}
{{Fixation - standard}}</noinclude>
==Gross processing==
==Gross processing==
*Count the number of fragments. They can be classified as “multiple” at over 5 or 6 specimens. Possibly add “Mixed with luminal material”.  
*Count the number of fragments. They can be classified as “multiple” at over 5 or 6 specimens. Possibly add “Mixed with luminal material”.  
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*Biopsies that are thicker than about 3-4 mm generally need to be bisected.
*Biopsies that are thicker than about 3-4 mm generally need to be bisected.


==Microscopic examination===
==Microscopic examination==
{{Moderate-begin}}Read the endoscopy report before evaluating (except for polyp biopsies, where it can be presumed that the purpose is to look for dysplasia).{{Moderate-end}}<ref group="note">'''Need to read endoscopy report''': If at least a short description of the indication is given in the order, the endoscopy report can be reviewed selectively, such as:
*Suspected Barrett esophagus: Knowing the Prague classification, exact biopsy levels, and whether salmon-colored mucosa was seen helps correlate with intestinal metaplasia.
*Inflammatory bowel disease: Distribution and endoscopic severity can help distinguish main conditions.
*Masses or ulcers: Appearance (fungating, infiltrative, submucosal, healed ulcer) helps when biopsies are scant or nondiagnostic.
*Microscopic colitis workup: Knowing that the colon appeared endoscopically normal supports the clinical context.
*Discordant findings: For example, severe endoscopic esophagitis with minimal histologic changes, or vice versa.
*Cases where the diagnosis affects staging or management: Such as EMRs/ESDs, dysplasia surveillance, unusual lesions or scant material.
</ref>
===Example normal reports===
===Example normal reports===
Further information in main articles of each location.
;[[Esophagus]]:
;[[Esophagus]]:
{|class=wikitable
{|class=wikitable
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;[[Gastroesophageal junction]]:
;[[Gastroesophageal junction]]:
{|class=wikitable
{|class=wikitable
| {{Moderate-begin}}GE junction, biopsy:{{Moderate-end}}<br>Squamous mucosa, '''negative''' for significant histopathologic changes.<br>{{Moderate-begin}}Negative for gastric mucosa or intestinalized (Barrett's) mucosa.{{Moderate-end}}
| {{Moderate-begin}}GE junction, biopsy:{{Moderate-end}}<br>Squamous and gastric mucosa without significant histopathologic changes.<br>{{Moderate-begin}}Negative for intestinalized (Barrett-type) mucosa.{{Moderate-end}}
|}
|}


;[[Stomach]]:
;[[Stomach]]:
{|class=wikitable
{|class=wikitable
| {{Moderate-begin}}Gastric, biopsy:{{Moderate-end}} Gastric mucosa without significant pathologic changes.<br>{{Comprehensive-begin}}Negative for helicobacter pylori organisms on H&E slide.{{Comprehensive-end}}
| {{Moderate-begin}}Stomach, biopsy:{{Moderate-end}}<br>Gastric mucosa without significant histopathologic changes.<br>{{Comprehensive-begin}}Negative for ''Helicobacter pylori'' organisms on H&E slide.{{Comprehensive-end}}
|}
|}


;[[Duodenum]]:
;[[Duodenum]]:
{|class=wikitable
{|class=wikitable
| (Small bowel, biopsy:) Duodenal mucosa without significant histopathologic changes. (Negative for celiac disease.)
| {{Moderate-begin}}Small bowel, biopsy:{{Moderate-end}}<br>Small intestinal mucosa without significant histopathologic changes.<br>{{Comprehensive-begin}}Negative for celiac disease.{{Comprehensive-end}}
|}
 
;Terminal ileum
{|class=wikitable
| {{Moderate-begin}}Small bowel, biopsy:{{Moderate-end}}<br>Small intestinal mucosa without significant histopathologic changes.<br>{{Comprehensive-begin}}Negative for ileitis.{{Comprehensive-end}}
|}
|}


;[[Colon]]:
;[[Colon]]:
{|class=wikitable
{|class=wikitable
| Colonic mucosa, negative for significant histopathologic changes.
| {{Moderate-begin}}Colon, biopsy:{{Moderate-end}}<br>Colonic mucosa without significant histopathologic changes.<br>{{Comprehensive-begin}}Negative for colitis.{{Comprehensive-end}}
|}
|}
 
<noinclude>
{{Bottom}}
{{Bottom}}</noinclude>

Latest revision as of 12:27, 28 July 2026

Author: Mikael Häggström [note 1]

Endoscopic biopsies   edit
Mostly:

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Fixation

Generally 10% neutral buffered formalin.

Gross processing

  • Count the number of fragments. They can be classified as “multiple” at over 5 or 6 specimens. Possibly add “Mixed with luminal material”.
  • Preferably stain with eosin if any fragment is smaller than about 0.3 cm
  • Biopsies that are thicker than about 3-4 mm generally need to be bisected.

Microscopic examination

(Read the endoscopy report before evaluating (except for polyp biopsies, where it can be presumed that the purpose is to look for dysplasia).)[note 2]

Example normal reports

Further information in main articles of each location.

Esophagus
(Middle third esophagus, biopsy:)
Squamous mucosa without significant histopathologic changes.
(Negative for eosinophilic esophagitis.)
Gastroesophageal junction
(GE junction, biopsy:)
Squamous and gastric mucosa without significant histopathologic changes.
(Negative for intestinalized (Barrett-type) mucosa.)
Stomach
(Stomach, biopsy:)
Gastric mucosa without significant histopathologic changes.
((Negative for Helicobacter pylori organisms on H&E slide.))
Duodenum
(Small bowel, biopsy:)
Small intestinal mucosa without significant histopathologic changes.
((Negative for celiac disease.))
Terminal ileum
(Small bowel, biopsy:)
Small intestinal mucosa without significant histopathologic changes.
((Negative for ileitis.))
Colon
(Colon, biopsy:)
Colonic mucosa without significant histopathologic changes.
((Negative for colitis.))

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
  2. ↑ Need to read endoscopy report: If at least a short description of the indication is given in the order, the endoscopy report can be reviewed selectively, such as:
    • Suspected Barrett esophagus: Knowing the Prague classification, exact biopsy levels, and whether salmon-colored mucosa was seen helps correlate with intestinal metaplasia.
    • Inflammatory bowel disease: Distribution and endoscopic severity can help distinguish main conditions.
    • Masses or ulcers: Appearance (fungating, infiltrative, submucosal, healed ulcer) helps when biopsies are scant or nondiagnostic.
    • Microscopic colitis workup: Knowing that the colon appeared endoscopically normal supports the clinical context.
    • Discordant findings: For example, severe endoscopic esophagitis with minimal histologic changes, or vice versa.
    • Cases where the diagnosis affects staging or management: Such as EMRs/ESDs, dysplasia surveillance, unusual lesions or scant material.

Main page

References


Image sources


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