Technical aspects in endoscopic biopsy of lesions in esophageal pemphigus vulgaris.
OBJECTIVE
Aim of this study is to compare a specific kind of biopsy forceps to a traditional one in providing an adequate specimen of esophageal pemphigus vulgaris lesions that includes the basement membrane for definitive diagnosis.


METHODS
Prospective, randomized, blind, single-center study. We performed upper endoscopy with biopsy in 32 patients divided into two groups of 16 each: in group A with a commercially available standard biopsy forceps while in group B with a commercially available rocking biopsy forceps. Hundred-ninety-six biopsy specimens from both groups were blindly evaluated by the same pathologist.


RESULTS
In group A 18.8% of biopsy specimens were adequate (basement membrane included). In group B 87.5% of biopsy specimens were adequate. The presence of the entire thickness of the mucosa was significantly higher in group B compared to group A. All parameters typically taken into account by pathologist for diagnosis of esophageal pemphigus vulgaris were significantly improved in group B.


CONCLUSIONS
The biopsy forceps used in group B permits a rocking motion of the tip on contact with the mucosa, produces a deeper full-thickness mucosal sample up to the basement membrane and assists in the evaluation of histologic features of esophageal pemphigus vulgaris.
Galloro
G
G
Department of General, Geriatric, Oncological Surgery and Advanced Technologies, Special Section of Surgical Digestive Endoscopy, School of Medicine, University Federico II of Naples, Via S. Pansini, 5, 80132 Naples, Italy. galloro.g@tin.it
Diamantis
G
G
Magno
L
L
Inzirillo
M
M
Mignogna
M C
MC
Mignogna
C
C
De Rosa
G
G
Iovino
P
P
D000328:Adult; D000368:Aged; D001485:Basement Membrane / Q000473:pathology; D001706:Biopsy / Q000295:instrumentation* / Q000379:methods; D004311:Double-Blind Method; D004867:Equipment Design; D004935:Esophageal Diseases / Q000473:pathology*; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010392:Pemphigus / Q000473:pathology*; D011446:Prospective Studies; D013525:Surgical Instruments