Gastric Biopsies: Increasing the Yield

Gastric biopsies can provide useful information beyond the identification of inflammation or Helicobacter organisms. The key to maximizing the diagnostic yield is providing sufficient context, adequate sampling, and good communication. Clinical information including medical history, surgical procedures, endoscopic impression, and imaging findings aids in detection and classification of findings. Adequate biopsies entail good sampling technique, proper labeling, and submission. Histologic evaluation can be enhanced by special stains, ancillary studies, and working knowledge of the diversity of diagnoses. Difficult cases are best managed by a combined clinicopathologic approach.