S2053 Interinstitutional Comparison of Small Bowel Pathology Reporting: Impact on the Diagnosis of Celiac Disease

Abstract

G A A b st ra ct s inclusion in formalin (Group 1) and the rest were directly included in formalin (Group 2). All biopsies were reviewed blind by two pathologists and consensus was reached about their mucosal orientation and epithelium integrity. Results. Biopsies from20 patients were included (mean age 31.05, δ2 14.81, 13 women/7 men, 5 pediatric cases). AcTG were positive in 7 patients. HLA DQ2 was present in 15 patients, HLA DQ8 in 3 patients, 2 patients presented both HLA types. One hundred and twelve biopsies were obtained (mean 5.6 per patient, δ2 0.76). Two patients presented intraepithelial lymphocytosis compatible with Marsh 1, 7 patients presented a Marsh III lesion, 1 patient a non-specific chronic duodenitis and the rest were normal. Group 1 comprised by 59 biopsies (mean 2.95 per patient, δ2 0.88) and there were 53 biopsies in group 2 (mean 2.65 per patient, δ2 0.59). The pathologist considered the mucosa to be well-oriented in 84 % (50/59) of biopsies of group 1 vs. 47 % (25/53) in group 2 (p<0.001). Twelve biopsies of group 1 and 13 biopsies of group 2 were denudated (p N.S.). Only three patients had one or no biopsy belonging to Group 1 well oriented vs. 13 patients when biopsies of group 2 were considered (p=0.003). Conclusions. A significant proportion of endoscopic duodenal biopsies are not well-oriented. Manual orientation of duodenal endoscopic biopsies at the moment of their obtention is useful to improve their quality without its manipulation affecting the integrity of the epithelium.