CORRELATION BETWEEN ENDOSCOPIC FINDINGS AND HISTOPATHOLOGIC DIAGNOSIS IN PATIENTS WITH GASTROINTESTINAL LESIONS
Mahmoud Tag El-Sabah1 and Mohamed Ali Awadein2
1Pathology Department, College of Medicine, MUST University,6th October City, Giza, Egypt
2Internal Medicine Department, College of Medicine, MUST University, 6th October City, Giza, Egypt
Background: Gastrointestinal tract lesions are one of the most commonly encountered problems in the clinical practice. A variety of disorders can affect the gastrointestinal tract with different clinical presentations. Endoscopy in combination with biopsy and histopathologic examination plays an important role in the definitive diagnosis for further management. Objectives: This study was conducted to evaluate the various histopathological lesions in gastrointestinal tract and to correlate between endoscopic findings and histopathologic diagnosis in patients with gastrointestinal lesions. Patients and methods: A retrospective study was carried out on 300 patients who presented to endoscopic unit of MUST University in the period between October 2017 and September 2019. Endoscopic biopsies were picked up by gastroenterologist endoscopic specialist doctor and the biopsies were fixed in 10% neutral formalin and delivered to pathology lab at MUST University hospital. Paraffin blocks were performed and sections were stained with routine Hematoxylin and Eosin stain. Age, sex, clinical presentation and endoscopic gross findings were recorded and correlated with histopathologic results. Results: In the present study, out of 300 patients included, there were 180 (60%) males and 120 (40%) females with male to female ratio 1.5:1. The age of the patients was ranged from 23 to 72 years with mean age of presentation 54 years. Out of 200 upper gastrointestinal biopsies 30 esophageal biopsies were performed, out of them 28 (14%) were non neoplastic. Histopathologic examination revealed reflux esophagitis in 20 (10%) patients and Barrett’s esophagus in 8 (4%) patients. The remaining 2 (1%) biopsies were diagnosed as squamous cell carcinoma. Out of 150 gastric biopsies, 133 (66.5%) were non neoplastic. Chronic active gastritis (n=50) (25%) was the most common histopathologic diagnosis followed by inflammatory gastric ulcer (n=23) (11.5%). The remaining 17 (8.5%) biopsies were neoplastic. Gastric adenoma was diagnosed in 12 (6%) patients and gastric adenocarcinoma was diagnosed in the remaining 5 (2.5%) patients. All the 20 duodenal biopsies were non neoplastic and diagnosed as non- specific duodenitis (n=15) (7.5%) and inflammatory duodenal ulcer (n=5) (2.5%). Concerning the 100 lower gastrointestinal biopsies, 10 endoscopic biopsies of ileum were performed and they were all non neoplastic. Non-specific inflammation was diagnosed in 8 (8%) biopsies and Crohn’s disease was diagnosed in the remaining 2 (2%) biopsies. Out of 90 colorectal biopsies received, 65 (65%) were non neoplastic. Chronic non-specific colitis was the most common (n=45) (45%) histologic diagnosis followed by inflammatory polyp (n=15) (15%) and ulcerative colitis (n=5) (5%). The remaining 25 (25%) biopsies were neoplastic. Adenomatous polyps were diagnosed in 20 (20%) biopsies and colorectal carcinoma was diagnosed in the remaining 5 (5%) biopsies. Conclusion: Histopathological examination of GI endoscopic biopsies is essential to diagnose and confirm the clinical presentations and endoscopic findings. Pathologic diagnosis is crucial to clarify non neoplastic and neoplastic GI lesions, thus allowing an early therapeutic intervention without unnecessary delay.