Biopsy: handling, processing and interpretation

image of Biopsy: handling, processing and interpretation
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This chapter is made up of three parts: 5a Gastrointestinal immunology; 5b Biopsy: sample collection; 5c Biopsy: handling, processing and interpretation. The gastrointestinal (GI) tract has the highest concentration of immunological tissue within the body, which is not surprising given the continual bombardment of the GI mucosal surface with antigenic material. A clear knowledge of the anatomy and function of the GI system is essential for understanding the pathogenesis and management options for the spectrum of immune-mediated diseases that affect the GI tract (e.g. inflammatory bowel disease; dietary hypersensitivity; small intestinal bacterial overgrowth; antibiotic-responsive diarrhoea).

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5.25 Sections from (a) endoscopic and (b) full-thickness biopsy samples of small intestine showing the relative levels of tissue sampled by these procedures. The endoscopic sample does not include tissue beneath the level of the mucosa. H&E stained sections.
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5.26 Sections from (a) a needle core and (b) a wedge biopsy of liver showing the relative amount of tissue sampled by these procedures. The wedge biopsy includes many more complete hepatic units for assessment. H&E stained sections.
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5.27 Sections of endoscopic biopsy samples demonstrating common artefacts seen with this procedure. (a) Crush artefact with loss of discernible tissue and cellular structure. (b) Cross-section of isolated villi when tissue is not orientated in a perpendicular fashion. (c) Fragmentation of a small tissue biopsy. H&E stained sections.
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5.29 Sections of liver stained by (a) Perl’s Prussian blue for haemosiderin and (b) rubeanic acid for copper. These stains are to investigate the nature of the cytoplasmic, brown, granular pigment observed within hepatocytes on a routine H&E section.
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5.30 Principle of immunohistochemistry. Target antigens within tissue are identified by a primary antibody, which is in turn bound by a secondary antibody that is chemically conjugated to either a fluorochrome or enzyme (typically peroxidase). The target antigen is visualized by exciting the fluorochrome with light of an appropriate wavelength, or generating local colour change following the addition of substrate.
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5.31 Section of small intestinal villus from a dog with alimentary lymphoma. (a) The H&E stained section shows replacement of normal mucosal structure by a diffuse sheet of neoplastic round cells with mitotic activity. (b) These are identified as T lymphocytes by immunohistochemical expression of CD3.
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