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Abrasive brush cytology has been used in many different fields of tissue sampling. Typical endoscopic brush is constrained within a plastic catheter similar to endoscopic snares (Figure 1.7).

After passing through the accessory channel of the endoscope, the abrasive brush is exposed and rubbed against the area of tissue sampling. This is most commonly applied to obtain specimens for microbiology, particularly fungal specimens. These have also been widely applied in the biliary tract for sampling of suspicious biliary strictures. More recent advances include a highly abrasive wide‐area tissue sampling system that has been recently studied and Barrett's esophagus as an alternative to pinch forceps, as well as nonendoscopic abrasive sponge sampling, which has the potential to offer inexpensive population‐based screening for esophageal neoplasia (Figure 1.8).

Figure 1.8 Nonendoscopic abrasive cytology brush.

Source: From Kadri, S.R., Lao‐Sirieix, P., O'Donovan, M. et al. (2010). Acceptability and accuracy of a non‐endoscopic screening test for Barrett's oesophagus in primary care: cohort study. BMJ341: c4372. doi: https://doi.org/10.1136/bmj.c4372. Open access article.