The two most common types of polyps are hyperplastic polyp and adenoma. The hyperplastic polyp is not at risk for cancer, while the adenoma is thought to be the precursor for almost all colon cancers. A biopsy is the only way to differentiate between hyperplastic and adenomatous polyps.
“Biopsies can be taken in the esophagus, stomach, small intestine and colon," said Jen Veasey, product manager for US Endoscopy. “ASGE states that histopathologic evaluation is helpful to differentiate malignant, inflammatory and infectious processes. Therefore, biopsies should be taken of any suspect tissue or as a follow-up to an earlier endoscopic procedure to evaluate prior therapy."
If a part of the body looks abnormal, it should be biopsied. However, there are a number of other reasons to take biopsies during a colonoscopy, according to Christopher Lawrence, MD, spokesperson for ASGE.
“For example, even if the lining of the colon looks normal, we will biopsy it on a patient who has diarrhea to rule out microscopic colitis," he said. “Many times, a diagnosis only can be made microscopically. A biopsy can be taken to diagnose Helicobacter pylori, and a biopsy of the duodenum is needed to diagnose and evaluate Celiac disease."
“Many of the GI societies recommend a once-in-a-lifetime screening for Barrett’s Esophagus," Lawrence said. “If we see something that resembles it, it requires a biopsy to diagnosis it."