Article Text

This article has a correction. Please see:

Download PDFPDF
ACP Best Practice No. 155. Guidelines for handling oesophageal biopsies and resection specimens and their reporting
  1. Nassif B N Ibrahim1
  1. 1Department of Histopathology, Frenchay Hospital, Bristol BS16 1LE, UK
  1. Dr Ibrahim email: nassif.ibrahim{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

The importance of the role of the histopathologist in the management of patients with oesophageal disease cannot be overemphasised. Pathological examination of specimens from these patients provides:

  • Essential diagnostic and prognostic information for optimal clinical management.

  • Material for research and audit.

  • A database for epidemiological studies.

A close liaison between the surgeon, gastroenterologist, and histopathologist is of paramount importance, particularly in the evaluation of dysplasia or early carcinoma in Barrett's oesophagus and, generally, to maximise diagnostic yield in any situation. The extent and usefulness of pathological information that can be conveyed to the clinicians is determined by the adequacy of clinical information, biopsy sampling, handling, laboratory processing, and any special studies that may be required. It is also influenced by the awareness of the histopathologist of the normal anatomy and histology of the oesophagus. There should be regular meetings between the surgeon, gastroenterologist, and histopathologist to discuss clinical and pathological findings.

Collection and preservation of specimens

The endoscopist should ensure that a separate container is used for biopsies taken from different sites so that the precise location of each biopsy can be identified. Containers should be properly labelled, including the number and site of the biopsy (for example, biopsy No 2 at 33 cm). Interpretation of the biopsy is considerably enhanced if it is taken with a large forceps and oriented1 (with its mucosal surface, if it is identifiable, upwards on small squares of porous non-soluble paper tissue) and placed immediately in an appropriate fixative (usually buffered 10% formalin or 10% formol saline). Biopsies should then be processed, embedded, and cut correctly oriented, having their luminal surface on one side of the section and the submucosal surface on the other. This is particularly important for the assessment of epithelial dysplasia or stromal invasion. However, small fibreoptic biopsies and those for malignant disease usually do …

View Full Text

Linked Articles

  • BMJ Publishing Group Ltd and Association of Clinical Pathologists