Endoscopic gastrointestinal biopsies: Difference between revisions

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|author1=[[User:Mikael Häggström|Mikael Häggström]]
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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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==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 any malignancy).{{Moderate-end}}
{{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.
Further information in main articles of each location.
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;[[Gastroesophageal junction]]:
;[[Gastroesophageal junction]]:
{|class=wikitable
{|class=wikitable
| {{Moderate-begin}}GE junction, biopsy:{{Moderate-end}}<br>Squamous mucosa without 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}}<br>Gastric mucosa without significant histopathologic 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
| {{Moderate-begin}}Small bowel, biopsy:{{Moderate-end}}<br>Duodenal mucosa without significant histopathologic changes.<br>{{Comprehensive-begin}}Negative for celiac disease.{{Comprehensive-end}}
| {{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}}
|}
|}


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| {{Moderate-begin}}Colon, biopsy:{{Moderate-end}}<br>Colonic mucosa without significant histopathologic changes.<br>{{Comprehensive-begin}}Negative for colitis.{{Comprehensive-end}}
| {{Moderate-begin}}Colon, biopsy:{{Moderate-end}}<br>Colonic mucosa without significant histopathologic changes.<br>{{Comprehensive-begin}}Negative for colitis.{{Comprehensive-end}}
|}
|}
 
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