What biopsy technique should be used to sample an esophageal ulcer?
- The exact number of biopsies required for maximal sensitivity and specificity is not clearly established, but several studies suggest the range of 8 to 10 . It is important to obtain biopsy samples from the ulcer margin and from the ulcer base.
- This is because biopsy of the ulcer edge reveals a cytopathic effect that is present in squamous epithelium associated with HSV; conversely, CMV resides in granulation tissue in the ulcer base.
- The role of culture and cytologic examination for esophageal ulcers is not settled.
- If all biopsies are negative for viral, bacterial, fungal, and parasitic infections, a diagnosis of IEU can be made.
