Endoscopic gastrointestinal biopsies
(Redirected from GI bx)
Author:
Mikael Häggström [note 1]
| 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.
| (Middle third esophagus, biopsy:) Squamous mucosa without significant histopathologic changes. (Negative for eosinophilic esophagitis.) |
| (GE junction, biopsy:) Squamous and gastric mucosa without significant histopathologic changes. (Negative for intestinalized (Barrett-type) mucosa.) |
| (Stomach, biopsy:) Gastric mucosa without significant histopathologic changes. ((Negative for Helicobacter pylori organisms on H&E slide.)) |
| (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, biopsy:) Colonic mucosa without significant histopathologic changes. ((Negative for colitis.)) |
Notes
- ↑ 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.
- ↑ 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