Polyps in the gastrointestinal tract: discrepancy between endoscopic forceps biopsies and resected specimens

Abstract

Considerable discrepancies were observed in histological findings between the EFB and the resected specimens. Therefore, complete removal of the entire polyp is recommended to confirm the diagnosis, to remove precancerous lesions, and to develop an optimal management plan.

Gastric Adenoma with Low-Grade Dysplasia: Two Countries, Two Outcomes

“…They reported that a lesion size C2 cm, the presence of erythema, or depressed lesions were significantly associated with an upgraded histology, consistent with previous Korean studies reporting that EGC diagnosed initially with endoscopic biopsy can be underdiagnosed as LGD [2][3][4][5]. Yet, in Japan, where the term ''adenoma with low-grade atypia'' is used to describe a lesion, concerns might be raised about the endoscopic resection of adenomas with LGD.…”

Magnifying endoscopy with narrow-band imaging helps determine the management of gastric adenomas

“…The histology of pre-treatment forceps biopsy samples does not always accurately identify malignancies, while tissue from endoscopic resection (ER) tends to yield a more accurate histological diagnosis. The discrepancy rate between forceps biopsy and ER has ranged from about 20 to 45% [5][6][7]. This discrepancy calls into question the accuracy of forceps biopsy in differentiating adenomas from cancerous lesions.…”

“…The malignant potential of gastric adenoma is thought to be relatively low [4]. However, we often find that the pre-treatment biopsy of gastric lesions supports a diagnosis of non-invasive low-grade neoplasia, but after ER histology is upgraded to high-grade neoplasia or invasive neoplasia [5][6][7]. One reason for this diagnostic imprecision is that small biopsy samples often do not contain enough tissue for an accurate judgment of structural atypia [8].…”

Predictive factors suggesting an underestimation of gastric lesions initially diagnosed as adenomas by forceps biopsy

“…However, some of the adenomatous lesions may be misdiagnosed before treatment. The discrepancy rates between forceps biopsy samples and post-resected specimens ranged from 20% to 40% in previous reports (20)(21)(22)(23). Discrepancies occur because the amount of tissue obtained by forceps biopsy is too small to represent the histology of the entire tumor le- sion.…”