Interpretation of Colonic Biopsies in Patients with Diarrhea
Accurate biopsy interpretation rests heavily on excellent communication between the endoscopist and the pathologist. We cannot overemphasize the importance of communication. Without proper clinical information, the pathologist may render an unhelpful or, worse yet, misleading diagnosis. Some pathologists prefer to arrive at an independent histopathologic diagnosis without first looking at the history or clinical question to avoid interpretation bias. However, the only approach for consistent, precise diagnoses in colonic biopsy pathology is the one that ultimately combines all pertinent information available from clinical, radiological, and laboratory sources, with the histopathogy to arrive at the final interpretation. A strikingly realistic study pitting histopathologic interpretation alone against a composite approach (clinical, radiologic, endoscopy, histopathology) in the diagnosis of colitis confirmed that the composite approach led to greater agreement and definitiveness (1). A schematic representation of the composite approach to diagnosis is given in Fig. 1.
KeywordsLamina Propria Ischemic Colitis Mucosal Biopsy Colonic Biopsy Microscopic Colitis
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