Gastric biopsy: Contribution of technical processing
to the complete evaluation of endoscopic material
Grekou Á, Akritidou D.
We evaluated the histologic appearances of gastric biopsies with
gastritis in order to clarify if these vary in the several depths
of the paraffin block and if these variations affect the establishment
of a correct diagnosis. We studied 135 biopsies with gastritis
from 123 patients. Four levels from the paraffin block were taken
and a mean of 17 sections/biopsy were studied (range 8-28 sections/biopsy).
Haematoxylin and eosin sections were evaluated for the presence
of atrophy, intestinal metaplasia, active inflammation, lymphoid
follicles and Helicobacter pylori. Seventy- two cases (53%) showed
differences in histological appearances. These differences involved
the presence of lymphoid follicles (78%), intestinal metaplasia
(50%) atrophy (30%) and active inflammation (12,5%) and were independent
from the number of tissue samples included in the biopsy. No differences
were observed in the detection of H. pylori. Our findings indicate
that the study of multiple sections from several depths of the
paraffin block is necessary for the complete evaluation of lesions,
such as lymphoid follicles, intestinal metaplasia and atrophy,
because these are frequently focal. On the contrary, active inflammation
and H. pylori appear to have a more uniform distribution. The
systematic application of the proposed technical processing of
gastric biopsies is practical, economical and diagnostically safe.
Key words: Gastric biopsy, gastritis, technical process.
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