Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-23T13:12:23.130Z Has data issue: false hasContentIssue false

Chapter 1 - The Value of Gastrointestinal Biopsy

Published online by Cambridge University Press:  06 June 2020

Roger M. Feakins
Affiliation:
Royal Free London NHS Foundation Trust, London, UK
Get access

Summary

This chapter serves as a guide to gastrointestinal (GI) endoscopy for the histopathologist for benign pathology and outlines the value to endoscopists of GI biopsies. It sets out to explain to a histopathology audience the decision-making process that endoscopists undertake when performing an endoscopic procedure and, crucially, what they need in return in a pathology report. There are explanations as to the thought processes that lead to endoscopic biopsies both in macroscopic disease and, perhaps more importantly, when appearances are normal. There is a guide to each anatomical area detailing how, where, and when to take samples from each region from the oesophagus to the rectum, followed by detailed up-to-date explanations on the latest guidelines for endoscopic sampling for each disease state. For each anatomical area there are practice point summaries and for some diseases detailed endoscopic pictures. The goal of this chapter is to enhance the pathologist’s knowledge of endoscopy, benign GI disease, and national and international sampling guidelines. Finally, we hope it serves as a guide for enhanced discussion between endoscopists and pathologists and encourages a collaborative approach to disease diagnosis.

Type
Chapter
Information
Non-Neoplastic Pathology of the Gastrointestinal Tract
A Practical Guide to Biopsy Diagnosis
, pp. 1 - 12
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdalla, M, Dhanekula, R, Greenspan, M, et al. Dysplasia detection rate of confirmatory EGD in nondysplastic Barrett’s esophagus. Dis Esophagus Off J Int Soc Dis Esophagus. 2014;27(6):505–10. DOI:10.1111/j.1442-2050.2012.01431.x.Google Scholar
Fitzgerald, RC, di Pietro, M, Ragunath, K, et al. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett’s oesophagus. Gut. 2014;63(1):742. DOI:10.1136/gutjnl-2013-305372.CrossRefGoogle ScholarPubMed
Beg, S, Ragunath, K, Wyman, A, et al. Quality standards in upper gastrointestinal endoscopy: a position statement of the British Society of Gastroenterology (BSG) and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS). Gut. 2017;66(11):1886–99. DOI:10.1136/gutjnl-2017-314109.Google Scholar
Reid, BJ, Weinstein, WM, Lewin, KJ, et al. Endoscopic biopsy can detect high-grade dysplasia or early adenocarcinoma in Barrett’s esophagus without grossly recognizable neoplastic lesions. Gastroenterology. 1988;94(1):8190.Google Scholar
Liacouras, CA, Furuta, GT, Hirano, I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128(1):320.e6; quiz 21–2. DOI:10.1016/j.jaci.2011.02.040.CrossRefGoogle ScholarPubMed
El-Serag, HB, Sweet, S, Winchester, CC, Dent, J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2014;63(6):871–80. DOI:10.1136/gutjnl-2012-304269.CrossRefGoogle ScholarPubMed
Lundell, LR, Dent, J, Bennett, JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45(2):172–80.Google Scholar
Chadwick, G, Groene, O, Hoare, J, et al. A population-based, retrospective, cohort study of esophageal cancer missed at endoscopy. Endoscopy. 2014;46(7):553–60. DOI:10.1055/s-0034-1365646.Google Scholar
Midolo, P, Marshall, BJ. Accurate diagnosis of Helicobacter pylori: urease tests. Gastroenterol Clin North Am. 2000;29(4):871–8.Google Scholar
El-Zimaity, HM, Graham, DY. Evaluation of gastric mucosal biopsy site and number for identification of Helicobacter pylori or intestinal metaplasia: role of the Sydney System. Hum Pathol. 1999;30(1):72–7.Google Scholar
Mountford, RA, Brown, P, Salmon, PR, Alvarenga, C, Neumann, CS, Read, AE. Gastric cancer detection in gastric ulcer disease. Gut. 1980;21(1):917.Google Scholar
Goddard, AF, Badreldin, R, Pritchard, DM, Walker, MM, Warren, B, British Society of Gastroenterology. The management of gastric polyps. Gut. 2010;59(9):1270–76. DOI:10.1136/gut.2009.182089.Google Scholar
Dinis-Ribeiro, M, Areia, M, de Vries, AC, et al. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED). Virchows Arch. 2012;460(1):1946. DOI:10.1007/s00428-011-1177-8.CrossRefGoogle Scholar
Sleisenger, MH, Feldman, M, Friedman, LS, Lawrence, S, Brandt, LJ. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management.Philadelphia: Saunders/Elsevier; 2010.Google Scholar
Ciociola, AA, McSorley, DJ, Turner, K, Sykes, D, Palmer, JB. Helicobacter pylori infection rates in duodenal ulcer patients in the United States may be lower than previously estimated. Am J Gastroenterol. 1999;94(7):1834–40. DOI:10.1111/j.1572-0241.1999.01214.x.CrossRefGoogle ScholarPubMed
Ludvigsson, JF, Bai, JC, Biagi, F, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014;63(8):1210–28. DOI:10.1136/gutjnl-2013-306578.Google Scholar
Green, PHR. Celiac disease: how many biopsies for diagnosis? Gastrointest Endosc. 2008;67(7):1088–90. DOI:10.1016/j.gie.2007.12.035.CrossRefGoogle ScholarPubMed
Green, PHR, Cellier, C. Celiac disease. N Engl J Med. 2007;357(17):1731–43. DOI:10.1056/NEJMra071600.Google Scholar
Walker, MM, Talley, NJ. Clinical value of duodenal biopsies – Beyond the diagnosis of coeliac disease. Pathol – Res Pract. 2011;207(9):538–44. DOI:10.1016/j.prp.2011.08.001.Google Scholar
Evans, KE, Aziz, I, Cross, SS, et al. A prospective study of duodenal bulb biopsy in newly diagnosed and established adult celiac disease. Am J Gastroenterol. 2011;106(10):1837–742. DOI:10.1038/ajg.2011.171.Google Scholar
Gonzalez, S, Gupta, A, Cheng, J, et al. Prospective study of the role of duodenal bulb biopsies in the diagnosis of celiac disease. Gastrointest Endosc. 2010;72(4):758–65. DOI:10.1016/j.gie.2010.06.026.Google Scholar
Ravelli, A, Villanacci, V, Monfredini, C, Martinazzi, S, Grassi, V, Manenti, S. How patchy is patchy villous atrophy? Distribution pattern of histological lesions in the duodenum of children with celiac disease. Am J Gastroenterol. 2010;105(9):2103–10. DOI:10.1038/ajg.2010.153.Google Scholar
Lebwohl, B, Kapel, RC, Neugut, AI, Green, PHR, Genta, RM. Adherence to biopsy guidelines increases celiac disease diagnosis. Gastrointest Endosc. 2011;74(1):103–9. DOI:10.1016/j.gie.2011.03.1236.Google Scholar
Vogelsang, H, Hänel, S, Steiner, B, Oberhuber, G. Diagnostic duodenal bulb biopsy in celiac disease. Endoscopy. 2001;33(4):336–40. DOI:10.1055/s-2001-13702.Google Scholar
Lebwohl, B, Granath, F, Ekbom, A, et al. Mucosal healing and risk for lymphoproliferative malignancy in celiac disease: a population-based cohort study. Ann Intern Med. 2013;159(3):169–75. DOI:10.7326/0003-4819-159-3-201308060-00006.Google Scholar
Melton, SD, Feagins, LA, Saboorian, MH, Genta, RM. Ileal biopsy: clinical indications, endoscopic and histopathologic findings in 10,000 patients. Dig Liver Dis. 2011;43(3):199203. DOI:10.1016/j.dld.2010.08.004.CrossRefGoogle Scholar
Annese, V, Daperno, M, Rutter, MD, et al. European evidence based consensus for endoscopy in inflammatory bowel disease. J Crohns Colitis. 2013;7(12):9821018. DOI:10.1016/j.crohns.2013.09.016.Google Scholar
Bojic, D, Markovic, S. Terminal ileitis is not always Crohn’s disease. Ann Gastroenterol. 2011;24(4):271–5.Google Scholar
Offner, FA, Jao, R V, Lewin, KJ, Havelec, L, Weinstein, WM. Collagenous colitis: a study of the distribution of morphological abnormalities and their histological detection. Hum Pathol. 1999;30(4):451–7.Google Scholar
Tanaka, M, Mazzoleni, G, Riddell, RH. Distribution of collagenous colitis: utility of flexible sigmoidoscopy. Gut. 1992;33(1):6570.Google Scholar
Yen, EF, Pardi, DS. Review of the microscopic colitides. Curr Gastroenterol Rep. 2011;13(5):458–64. DOI:10.1007/s11894-011-0207-7.Google Scholar
Itzkowitz, SH, Present, DH, Crohn’s and Colitis Foundation of America Colon Cancer in IBD Study Group. Consensus conference: colorectal cancer screening and surveillance in inflammatory bowel disease. Inflamm Bowel Dis. 2005;11(3):314–21.Google Scholar
Pötzi, R, Walgram, M, Lochs, H, Holzner, H, Gangl, A. Diagnostic significance of endoscopic biopsy in Crohn’s disease. Endoscopy. 1989;21(2):60–2. DOI:10.1055/s-2007-1012901.Google Scholar
Yantiss, RK, Odze, RD. Optimal approach to obtaining mucosal biopsies for assessment of inflammatory disorders of the gastrointestinal tract. Am J Gastroenterol. 2009;104(3):774–83. DOI:10.1038/ajg.2008.108.Google Scholar
Wilcox, CM, Straub, RF, Schwartz, DA. Prospective evaluation of biopsy number for the diagnosis of viral esophagitis in patients with HIV infection and esophageal ulcer. Gastrointest Endosc. 1996;44(5):587–93.CrossRefGoogle ScholarPubMed
Subramanian, V, Mannath, J, Ragunath, K, Hawkey, CJ. Meta-analysis: the diagnostic yield of chromoendoscopy for detecting dysplasia in patients with colonic inflammatory bowel disease. Aliment Pharmacol Ther. 2011;33(3):304–12. DOI:10.1111/j.1365-2036.2010.04525.x.Google Scholar
Farraye, FA, Odze, RD, Eaden, J, et al. AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology. 2010;138(2):738–45. DOI:10.1053/j.gastro.2009.12.037.Google Scholar
Shen, B, Fazio, VW, Remzi, FH, et al. Comprehensive evaluation of inflammatory and noninflammatory sequelae of ileal pouch-anal anastomoses. Am J Gastroenterol. 2005;100(1):93101. DOI:10.1111/j.1572-0241.2005.40778.x.CrossRefGoogle ScholarPubMed
Bujanda, L, Cosme, A, Gil, I, Arenas-Mirave, JI. Malignant colorectal polyps. World J Gastroenterol. 2010;16(25):3103–111.Google Scholar
Rutter, MD, Chattree, A, Barbour, JA, et al. British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polyps. Gut. 2015;64(12):1847–73. DOI:10.1136/gutjnl-2015-309576.Google Scholar
Ross, WA, Ghosh, S, Dekovich, AA, et al. Endoscopic biopsy diagnosis of acute gastrointestinal graft-versus-host disease: rectosigmoid biopsies are more sensitive than upper gastrointestinal biopsies. Am J Gastroenterol. 2008;103(4):982–9. DOI:10.1111/j.1572-0241.2007.01639.x.Google Scholar
Thompson, B, Salzman, D, Steinhauer, J, Lazenby, AJ, Wilcox, CM. Prospective endoscopic evaluation for gastrointestinal graft-versus-host disease: determination of the best diagnostic approach. Bone Marrow Transplant. 2006;38(5):371–6. DOI:10.1038/sj.bmt.1705453.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×