Histopathological spectrum of duodenal biopsies: Experience at a tertiary care hospital

Abstract

Objective: Endoscopic duodenal biopsies constitute a significant load of specimens in the histopathological section of a tertiary care hospital. Most of these diseases comprise non-neoplastic lesions causing significant morbidity. The purpose of this study was to see the frequency of these diseases in our patient population and to compare and analyze our results with similar other studies.
 Methods: In this retrospective study records of all duodenal biopsies reported from Feb 2017- Jan 2018 were retrieved. Both non neoplastic and neoplastic conditions along with biopsies with unremarkable findings were included. Various histological parameters like villous blunting, IEL count per 100 enterocytes, crypt hyperplasia, inflammation in lamina propria, and presence of microorganisms, any dysplasia or malignancy were studied. Data was statistically analyzed using SPSS v.23.
 Results: A total of 159 duodenal biopsies were included in the study. Normal duodenal morphology was noted in 85 (53.45%) cases while 74 (46.83%) cases revealed abnormal duodenal pathology. There were 46 (28.93%) cases consistent with celiac disease. Twenty eight (17.61%) cases were of other duodenal pathologies of which non-specific duodenitis was most common. There were 22 (13.83%) cases of duodenitis and 2 (1.26%) cases were of duodenal ulcer. One case (0.62%) each was seen of Brunner gland hyperplasia, adenocarcinoma, signet ring carcinoma and one case was of metastatic adenocarcinoma.
 Conclusion: In our study we found a significant percentage of 46.83% exhibiting abnormal duodenal pathology. Cases consistent with celiac disease were 28.93% while 13.83% of the cases had duodenitis. The percentage of malignant cases was minimal (1.88%).