Zusammenfassung
Die histologische Diagnosesicherung mittels Biopsie spielt in vielen Fällen eine wesentliche Rolle bei der Diagnostik internistischer Erkrankungen. Der Gastrointestinaltrakt (z. B. Ösophagus, Leber und Kolon), die Nieren und das Knochenmark sind exemplarische Organ(system)e mit regelhafter biopsiebasierter Diagnostik und Therapieevaluierung. Verbesserte laborchemische, bildgebende und endoskopische Techniken haben die Möglichkeiten verbessert, eine Diagnose bereits makroskopisch bzw. nicht-invasiv zu sichern. Dadurch konnte die Biopsiefrequenz deutlich reduziert und die Biopsie in bestimmten Bereichen sogar ersetzt werden. Die histologische Beurteilung der Biopsie bleibt jedoch ein wesentlicher Standard der internistischen Diagnostik. Ziel dieser Übersicht ist, die aktuellen Standards und Möglichkeiten der pathologischen Diagnostik nach Biopsie und moderne Entwicklungen nicht-invasiver Methoden heute und in Zukunft darzustellen.
Abstract
Histological evaluation after biopsy remains the gold standard for the diagnosis of numerous diseases in Internal Medicine. The gastrointestinal tract (e. g. esophagus, liver and large intestine), the kidneys or bone marrow are organs, where biopsy-driven diagnosis and evaluation of therapeutic regimens are of major relevance. Improvement in blood analysis, endoscopic techniques and radiology could significantly reduce the number of biopsies. Hence under certain circumstances, the risk of biopsy can be avoided and non-invasive markers can sufficiently substitute the histological evaluation. However, histological evaluation derived from biopsies remains the standard of diagnosis in many cases in Internal Medicine. In the present review the current standards and future developments of pathologic diagnosis through biopsy are illustrated.
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Die Arbeit wird durch den SFB TRR57 der Deutschen Forschungsgemeinschaft unterstützt.
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Knüchel-Clarke, R., Lutz, H., Floege, J. et al. Wenn nur noch der Pathologe hilft. Internist 51, 463–472 (2010). https://doi.org/10.1007/s00108-009-2453-4
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DOI: https://doi.org/10.1007/s00108-009-2453-4