Hello all.
I know we have quite a few medical members about. Are any of you pathologists? None of my friends went into pathology and I have a protocol question.
I recently read that pathologists don't quantify/count eosinophils per HPF if just distal esophageal biopsies are taken. Is this true?
Back story if you care: I'm in primary care pediatrics. My son's ENT is suspicious that he might have eosinophilic esophagitis. His GI disagrees because his last scope (which took 2 distal esophageal biopsies and none medial or proximal) read "normal appearing" without providing a count of actual eos. I'm extra suspicious because the macroscopic observations noted "white plaques" throughout the esophagus which were negative for candida. This, in addition to FTT, reflux symptoms unimproved by a dose of Prevacid *i* would take, routine choking/coughing with feeds and feeding aversions have me worried we are missing something more than GERD.
Because I recently read that protocol suggests pathologists reviewing just distal biopsies needn't count eos per HPF, I'm wondering if I should request to have his slides pulled and counted. If this is untrue then I will simply follow up with GI, allergy and ENT as planned.
Thank you very much!!
I know we have quite a few medical members about. Are any of you pathologists? None of my friends went into pathology and I have a protocol question.
I recently read that pathologists don't quantify/count eosinophils per HPF if just distal esophageal biopsies are taken. Is this true?
Back story if you care: I'm in primary care pediatrics. My son's ENT is suspicious that he might have eosinophilic esophagitis. His GI disagrees because his last scope (which took 2 distal esophageal biopsies and none medial or proximal) read "normal appearing" without providing a count of actual eos. I'm extra suspicious because the macroscopic observations noted "white plaques" throughout the esophagus which were negative for candida. This, in addition to FTT, reflux symptoms unimproved by a dose of Prevacid *i* would take, routine choking/coughing with feeds and feeding aversions have me worried we are missing something more than GERD.
Because I recently read that protocol suggests pathologists reviewing just distal biopsies needn't count eos per HPF, I'm wondering if I should request to have his slides pulled and counted. If this is untrue then I will simply follow up with GI, allergy and ENT as planned.
Thank you very much!!
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