Endoscopic Mucosal Tissue Sampling

Publication Date: August 1, 2013
Last Updated: March 14, 2022

Tissue sampling recommendations and suggestions

Esophagus

GERD

Targeted biopsies of irregular mucosa, if clinically warranted. (S, L)
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BE

Surveillance of nondysplastic BE: 4-quadrant biopsies every 2 cm with large-capacity forceps for length of Barrett’s mucosa. (S, L)
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Surveillance of BE with LGD: 4-quadrant biopsies every 1-2 cm with large-capacity forceps for length of Barrett’s mucosa. (R, M)
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Surveillance of BE with HGD: 4-quadrant biopsies every 1 cm with large-capacity forceps for length of Barrett’s mucosa. (R, M)
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EoE

  • 2-4 biopsies from proximal esophagus
  • 2-4 biopsies from distal esophagus
  • Biopsies of gastric antrum and duodenum when EG suspected
  • Biopsies should not be placed in Bouin’s preservative
(S, L)
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Infectious esophagitis

Viral esophagitis
  • Multiple biopsies from margin and base of visualized ulcers
  • Specimens should be sent for standard histology, IHC, and possibly viral culture and PCR
(S, L)
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Candidal esophagitis
  • Multiple biopsies of affected area
  • Cytologic brushing complementary to biopsy
(S, L)
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Overview

Title

Endoscopic Mucosal Tissue Sampling

Authoring Organization

American Society for Gastrointestinal Endoscopy