Endoscopic and Histologic Diagnosis of Upper Gastrointestinal Lesions, Experience in a Port City of Bangladesh

Abstract

Background: For upper gastrointestinal tract disorders endoscopic biopsy is common procedure performed in the hospital for a variety of benign and malignant lesions. Endoscopy is incomplete without biopsy and histopathology is the gold standard for the diagnosis of endoscopically detected lesions. Methods: A prospective study was carried out at a private histopathology diagnostic center at Chittagong from October 2012 to September 2013. All the upper GIT endoscopic biopsy samples received during the period were included in the study. The endoscopy was done by a skilled endoscopist and his detail endoscopic findings were noted. After conventional tissue processing H&E stained slides are examined under light microscope by three competent histopathologists. Results: Among total 110 upper GIT endoscopic biopsy samples 22 (20%) were oesophageal, 73 (66.36%) gastric and 15 (13.64%) duodenal biopsies. Among oesophageal biopsies 18 (81.82%) were histologically neoplastic of which 13 (81.25%) were SCC and 03 (18.75%) adenocarcinoma. Rest 02 (9.09%) were leiomyoma. Among all the oesophageal carcinomas, 10 (62.5%) were provisionally diagnosed as carcinoma by endoscopists. Among 73 endoscopic biopsies from stomach, the mean age was 54.63 yrs. On histopathology among 73 patients, adenocarcinoma-33 (45.20%), gastric ulcer-11 (15.07%), gastritis-15 (20.55%) and hyperplastic polyp-14 (19.18%). Among 33 adenocarcinoma of stomach 23 (69.69%) were clinically diagnosed or suspected as carcinoma by the endoscopist. Among 15 duodenal biopsies 11 (73.33%) were diagnosed histologically as hyperplastic polyp, 02 (13.33%) as adenocarcinoma, 02 (13.33%) as ulcer. Among 110 UGIT biopsies total 51 (46.36%) were malignant. Mean age 59.49 yrs ranges from 22 Yrs to 82 Yrs. M:F ratio is 1.4:1. Among all 33 (64.7%) were gastric carcinoma, 16 (31.37%) oesophageal carcinoma and 02 (3.92%) duodenal carcinoma. Among 51, 35 (68.63%) were clinically diagnosed or suspected as carcinoma by endoscopist. No clinical information was available in 03 (5.88%) cases and rest 13 (25.49%) cases were clinically diagnosed as non neoplastic conditions by the endoscopist. Conclusion: Endoscopy followed by histopathological examination play important role for diagnosis and management of UGIT lesions.

Histopathological Study of Upper Gastrointestinal Tract Endoscopic Biopsies

“…Similar study were done by Hussain et al 5 and Shanmugasamy et al 7 showing male predominance. In this present study stomach biopsies constitute the majority of the cases (61) which is similar to other studies 5,6,8 . Frequencies of neoplastic lesions are 44.26% (27 cases) which is similar to Islam et al 8 .…”

“…In this study incidence of inflammatory lesion is more, which is similar to other studies 3,1 . Incidence of adenocarcinoma is 6.67% which is close to another study done by Islam et al 8 in Bangladesh (13.33%).…”

“…Among 135 cases endoscopist reported 82(60.74%) cases as neoplastic and 53(39.26%) as nonneoplastic, whereas Histopathology revealed 77(57.03%) as neoplastic and 58 (42.97%) as nonneoplastic. Out of 77 neoplastic lesion 75 (55.56%) are malignant which is higher than the study done by Islam et al 8 (46.36%). In this study though common site of Upper GIT lesion is stomach but highest incidence of malignant lesion in oesophagus (84.92%).…”

Morphological Spectrum of Lesions in Upper Gastrointestinal Endoscopic Biopsies

“…The study was conducted in the Department of Pathology Comparision with Gender: Gastric lesions are generally more common among males worldwide. The findings of the present study showed male predominance with male : female ratio of 1.17:1 and they are similar to the study of Rashmi et al [3] , Islam et al [5] ,Hussain et al [6] , K et al [7] ,Somani et al [9] , Khandelia et al [10] and Rani et all [11] . Increased exposure to risk factors and large number of male patients attending the hospital can explain the gender ratio.…”

Evaluating the spectrum of histomorphological patterns on endoscopic biopsy in patients with upper gastrointestinal tract disorders

“…Age and sex wise distribution of lesions of the present study reports showed that the most commonly affected age group was 31-40 years followed by 41-50 years. Our result is slightly contradict with the studies carried out by Shepherd NA [27], Shennak M M et al [28] and Islam SM et al [29], Wherein they studied the endoscopic biopsy for gastrointestinal tract lesions in which the commonly affected age group was between fifth and sixth decades of life.…”