Utility of Colonoscopic Biopsies in Histomorphological Spectrum of Colorectal Lesions - A Study in a Tertiary Care Centre in Aurangabad Region of Maharashtra

Abstract

BACKGROUND Colonoscopy is considered as a diagnostic procedure of choice for patients presenting with chronic diarrhoea / bloody diarrhoea. Colonoscopic mucosal biopsies have shown to be accurate indicators of extent of the involvement of colon in inflammatory bowel disease. Also, colonoscopy is still considered as the gold standard in cancer surveillance. The present study was undertaken to find out the utility of colonoscopic biopsies in histomorphological spectrum of colorectal lesions. METHODS This was a three-year retrospective study carried out in the Department of Pathology, at MGM Medical College, Aurangabad. Patient’s clinical details, colonoscopic findings and apparent pathology were noted in 206 cases along with final histopathological diagnosis. Biopsies which showed significant findings were included in the study. RESULTS In the study, the male to female ratio was 2.4 : 1. Out of 206 colorectal biopsies, 146 (70.8 %) were non-neoplastic and 60 (29.2 %) were neoplastic lesions. Amongst non-neoplastic lesions, maximum cases were of chronic colitis with 4 cases of granulomatous colitis and 30 cases of inflammatory bowel disease. Adenocarcinoma was the most common histologic type in neoplastic lesions (66.6 %), with rectum being the most common site followed by colonic polyps (25 %). As far as age group was concerned, the 2nd decade was dominated by chronic colitis, 3rd decade by adenomatous polyps and 5th decade by adenocarcinoma. CONCLUSIONS Histomorphological profile of colorectal biopsies has a wide spectrum ranging from infectious diseases, inflammatory bowel disorders to colorectal malignancies. Histopathology with correlation of clinical and endoscopic findings plays a major role in accurate diagnosis of colorectal lesions. KEYWORDS Colonoscopy, Biopsies, Neoplastic, Non-Neoplastic, Colitis, Adenocarcinoma