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Choosing the Right Biopsy for the Job: Gastrointestinal
The problem with gastrointestinal biopsies of inflammatory disease is not in capturing the samples, but in interpreting them. The normal cellularity of the stomach, small intestine or colon of dogs and cats has never been defined, which seems like a fairly fundamental problem when dealing with so-called inflammatory bowel disease in which the very definition of the disease is "too many" leukocytes. There is virtually no agreement among pathologists as to how many leukocytes qualifies as too many, and what proportion is allowed to be eosinophils before it becomes abnormal. Distinguishing severe inflammatory bowel disease from early malignant lymphoma with shallow endoscopic biopsies can be difficult or impossible. Full thickness samples allow observation of submucosal or even transmural infiltration by the lymphocytes in malignant lymphoma, and thus a much more certain diagnosis. The shortcoming applies only to early disease. With full-fledged lymphoma, even endoscopic samples should allow a definitive diagnosis.
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