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= | |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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==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 | {{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 | | {{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}} | | {{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> | | {{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}} | ||
|} | |} | ||
<noinclude> | |||
{{Bottom}} | {{Bottom}}</noinclude> | ||