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Author: Mikael Häggström [note 1]

Endoscopic biopsies   edit

Most common requests:


This article deals with esophageal biopsies. For resections, see: Esophagus resection


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

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

Microscopic evaluation

On esophageal biopsies, look at least for esophagitis:


GE junction with chronic esophagitis, including plasma cells (black arrow), an acute inflammation with neutrophils (white arrow), as well as basal layer hyperplasia (yellow double-headed arrow).

Look for signs of (reflux) esophagitis, mainly:[1]

  • Inflammatory cells, especially when intra-epithelial. Neutrophils confer a diagnosis of acute inflammation, while plasma cells, eosinophils and excess T cells confer a diagnosis of chronic inflammation. In eosinophil-predominant inflammation, also evaluate as suspected eosinophilic esophagitis.
  • Basal cell hyperplasia exceeding 15 - 20% of the epithelial thickness.
  • Stromal papillae reaching upper third of the epithelium.
  • Loss of orientation of superficial epithelial cells.
  • Ballooned squamous cells

Microscopy report

Example normal report for an esophagus biopsy:

(Middle third esophagus, biopsy:)
Squamous mucosa without significant histopathologic changes.
((Negative for eosinophilic esophagitis.))

Example report with signs of reflux:

(Mid esophagus, biopsy:)
Squamous mucosa with reactive changes consistent with reflux.
((Negative for eosinophilic esophagitis.))


  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.

Main page


  1. Elliot Weisenberg. Esophagus - Esophagitis - Reflux esophagitis / gastroesophageal reflux disease. Pathology Outlines. Topic Completed: 1 October 2012. Minor changes: 8 July 2020

Image sources