Spectrum of Histopathological Lesions in patients undergoing Gastroduodenal Biopsies in a Tertiary Care Centre in North Karnataka, India

Abstract

Introduction: Patients with Gastrointestinal (GI) symptoms usually present with alarming symptoms. The use of modern flexible gastroduodenoscope and the acquisition of the mucosal biopsy specimens have opened a window to the living tissues and have greatly improved the diagnostic facility for the GI lesions. It provides an in depth visual assessment of GI mucosa and allows sampling of tissue to the pathologist for further assessment. Aim: The aim of this study was to evaluate the spectrum of histopathological incidence of neoplastic and non-neoplastic lesions in patients undergoing gastroduodenal biopsy. Materials and Methods: This was a prospective study of 100 patients conducted over a period of one year and seven months, December 2010 to June 2012 with symptoms of gastroduodenal diseases who attended endoscopic unit of the tertiary care hospital in Bellary North Karnataka, South India. All biopsies done for various upper abdominal symptoms like pain abdomen, dyspepsia, haematemesis, mass per abdomen, and vomiting were included. Routine haematoxylin and eosin, special stains like Periodic Acid-Schiff (PAS) and Giemsa were done. Histopathological parameters evaluated included mucosa evaluation (ulceration, metaplasia, dysplasia, atrophy), type of inflammatory infiltrate, H.pylori infection and type of tumour. Data was analysed using descriptive analysis. Results: Among 100 patients, 76 were males and 24 were females. Highest percentage of study participants were in the age group of more than 58 years 30 (30%). The most common endoscopic presentation was gastric erythema in 42 (42%) cases followed by benign gastric ulcer 16 (16%) cases, ulcero proliferative growth 15 cases, and duodenal erythema 13 (13%) cases. The most common histopathological diagnosis amongst non-neoplastic lesions were chronic gastritis 44 (44%) cases chronic duodenitis 15 cases, and benign gastric ulcer 11 (11%) cases and amongst neoplastic lesions, most common was gastric adenocarcinoma 15 (15%) cases. Conclusion: Endoscopy gross findings are not disease specific hence, histopathological study of biopsy specimen can help in confirmation of the diagnosis.