Multiple Biopsies Taken, Only 1 Read?

[superfob]

Hi,

I just got my pathology report in the mail. All my results came back negative with "No significant pathologic abnormality". I tested TTG negative and AGA IgA positive, so I was hoping for some inflammation or increased lymphocytes, or partial atrophy.

I'm reading the description of my biopsies, and for duodenum it says "Received in formalin is a 0.3 x 0.2 x 0.2 cm fragment of tan tissue, submitted toto in 1 cassette C." It seems like they only read one biopsy??!

From the report, they also read 1 fragment from my ileum, 2 fragments from my stomach (antrum), and "multiple fragments" from my colon.

I'm so confused as why this is, because right after my procedure, when I got my report, it says "The examined duodenum was normal. Biopsies were taken with a cold forceps for evaluation of celiac disease x6" I assumed that this would mean 6 samples, but my pathology report is only saying one?

I know I need to ask my doctor about this, but the appointment is over a month away, so looking for some help interpreting this.

Thanks

[mushroom]

It appears you had both a colonoscopy and an endoscopy. Biopsy samples were submitted as follows: one from the duodenum; two from the stomach, one from the ileum (lower part of the small intestine, which would have to be obtained from the colonoscopy) and "multiple" fragments from the colon. So yes, there was only one sample taken from the upper part of the small intestine, the duodenum. I think it would be a case of only one sample being submitted, not of only one sample being read. The lab has an obligation to read what is submitted. I think the onus is on the doctor, not on the lab. I don't know why they would describe it as 6 samples testing for celiac when you cannot test for celiac from the colon.

[kareng]

It appears you had both a colonoscopy and an endoscopy. Biopsy samples were submitted as follows: one from the duodenum; two from the stomach, one from the ileum (lower part of the small intestine, which would have to be obtained from the colonoscopy) and "multiple" fragments from the colon. So yes, there was only one sample taken from the upper part of the small intestine, the duodenum. I think it would be a case of only one sample being submitted, not of only one sample being read. The lab has an obligation to read what is submitted. I think the onus is on the doctor, not on the lab. I don't know why they would describe it as 6 samples testing for celiac when you cannot test for celiac from the colon.

I agree with Shroomie. 6 total biopsies taken from different places. The part about the Celiac diagnosis was the pre- procedure diagnosis the doctor gave as a reason for the procedures. If that was the only diagnosis given the insurance company, they should not have approved a colonoscopy. Just show they don't get it either.

You will need to write a letter, probably several times,, to the insurance company. Include info from Celiac Disease Centers to explain why you must get a new GI and do the endo part again.

[superfob]

Hmmm, I think the "x6" part was specifically referring to the duodenum. There are other parts in the report where they talk about taking biopsies for the ileum and colon.

I guess the way I interpreted the report, was that my doctor took multiple samples during the procedure, but only sent off one to the lab.

O, and my doctor does know that Celiac can only be tested with samples from the small intestine. The colonoscopy was just to rule out other causes of my stool changes.

I'm just wondering why only one sample was sent to the lab, but I guess the only way to find out is to call his office/talk to him in person.

Sorry for the confusion!