[Erosive gastritis and single erosion]
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In erosive gastritis, taking biopsies from all the erosions is impossible. It is not even necessary. If you take biopsies from 10 erosions and one of them is cancer in pathology report, you may not localize the cancerous lesion in the repeat endoscopy. So, careful examination is more important than numerous biopsies.
When malignancy is not suspected in erosive esophagitis, you don't need to take a biopsy. If you are not sure about the findings, take some time to select most suspicious lesions and then take biopsies only from them. In practice, I usually don't take biopsy from more than 3 locations.
However, a small gastric cancer may be hidden among many erosions. Careful examination of every aspect of the gastric mucosal surface is important. In the following case, there were a lot of erosions at the lower body and the proximal antrum. In addition, a single large erosion with irregular edge was found at the anterior wall of the antrum. Two biopsies were taken and the result was signet ring cell carcinoma.
Single erosion may be benign or malignant. I recommend 2 biopsies for a single erosion. It is difficult to make a reliable pathological diagnosis with a tiny biopsy specimen. Two pieces of biopsy for one lesion may be better.
early gastric cancer