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

Abstract

Introduction: The upper gastrointestinal tract (UGT) disorders are more common complaints in clinical practice and have got high degree of mortality and morbidity. Many different types of lesions can affect the upper gastrointestinal tract and can be classified as congenital anomalies, infections, inflammation and neoplastic lesions. Material and Methods: A total of 152 cases of upper gastrointestinal tract biopsies are included in this study, out of which 113 cases were gastric biopsies, 22 cases were esophageal biopsies and the remaining 17 cases were duodenal biopsies. Present study was carried out in the Department of Pathology at Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry for a period of one year between March 2018 and February 2019. All the biopsies were performed using fiberoptic endoscopy. Endoscopic biopsy in combination with histopathological examination plays an important role in the early diagnosis of determining UGT lesions. Also, special stains like Giemsa, Warthin starry stain was used to demonstrate Helicobacter pylori. Aim of the study is to evaluate the histomorphological patterns of upper gastrointestinal tract disorders on endoscopic biopsy and to correlate various upper gastrointestinal tract disorders in correspondence to clinical parameters. Results: It is reported among 152 cases of UGT biopsies 137 were non-neoplastic lesions and 15 were neoplastic. Commonly affected age group was 31-40 years followed by 41 to 50 years. As per the present study, males were affected more predominantly than females. Out of the 22 cases from esophageal biopsies, 16 cases showed non-neoplastic lesions and 6 were neoplastic. The most common non-neoplastic lesion was chronic nonspecific esophagitis and neoplastic lesion reported was squamous cell carcinoma. Among 113 gastric biopsies, 104 cases were non-neoplastic lesions and 9 were neoplastic lesions. Adenocarcinoma was the predominant neoplastic lesion of stomach. All the 17 duodenal biopsies showed non-neoplastic lesions.

Histopathological spectrum of lesions of upper gastrointestinal tract – A study of endoscopic biopsies

“…depicts the histopathological spectrum observed in upper GIT biopsies in different studies. In the present study, non-neoplastic lesions outnumbered the neoplastic ones, which is in concordance with various studies [11][12][13]15,18. However, the studies of Bhargavi et al,Nazrin et al, and Dutta et al, showed neoplastic lesions to be the…”

“…H. pylori gastritis was commonly noted lesion in various studies. 10,13,15,16,18 Varied frequencies of H. pylori gastritis might be due to variables such as geographic area, age, race, ethnicity, and socioeconomic status. Rates appear to be higher in developing than in developed countries and they seem to be decreasing with improvements in hygiene practices and due to the availability of good antibiotics and antacids.…”

“…This strongly suggests a possible inflammatory nature of hyperplasic gastric polyps. However, the term inflammatory polyp is 12 , D: Bhat et al 13 , E: Nazrin et al 14 , F: Theresa et al 15 , G: Rani et al 16 , H: Krishnappa et al 18 a common misnomer for this polyp and that should be discouraged because it can be confused with inflammatory fibroid polyp, which is managed much differently. Examination of the surrounding mucosa is necessary in evaluating the underlying pathology (for example, H. pylori, autoimmune gastritis, or reactive gastropathy) in each case of hyperplastic polyp.…”

Histopathological spectrum of upper gastro intestinal lesions in endoscopic biopsies at a tertiary care centre

“…The Male to Female ratio was 1.39: 1, which was similar to the study done by Shennak MM et al 9 and Rashmi K et al 4 reflecting the fact that males could be exposed to more risk factors than females. In these studies, the men outnumbered women due to more prevalence of smoking, alcoholism, and stressful life similar to studies done by Paymaster et al 10 Among 21 esophageal biopsies, 18 (85%) were non neoplastic and 3 (15%) were neoplastic, the most common non neoplastic lesion was Esophagitis seen in 10 out of 21 cases also seen in Theresa JM et al 11 studies which followed barrettes esophagus and dysplasia. In the present study 100% concordance was seen in cases of esophagitis and barrettes esophagus on both endoscopic and histopathological diagnosis.…”

A Hospital-Based Cross-Sectional Study on the Histopathology of Upper Gastrointestinal Tract Endoscopic Biopsy in Dyspeptic Patients

“…Endoscopy was first used in 1986; the upper gastrointestinal flexible fiber optic endoscope revolutionized the way in which GIT abnormalities could be diagnosed [13]. Endoscopic biopsy examination followed by histologic assessment is a convenient procedure and the current gold standard for accurate objective assessment of patients with symptoms of upper GIT.…”