Histomorphological Profile of Colonoscopic Biopsies - A Two Year Study in a Tertiary Care Hospital in South India

Background: The Colonoscopy with accompanying mucosal biopsy is the prime diagnostic tool in the workup of patients with different neoplastic as well as non-neoplastic lesions of colon & rectum. The objectives of this study were to study the spectrum of lesions in colon & rectum on colonoscopic biopsies, to find age & sex distribution of these lesions & to correlate them with presenting complaints & anatomical site. Methods: The study included colonoscopic biopsies of colon & rectum from patients attending the department of surgery at SNMC & Hanagal Shri Kumareshwar Hospital & department of gastroenterology at Kerudi Hospital & Research Centre, Bagalkot from January 2012 to December 2013. There were 108 colonoscopic biopsies during this period, among which 105 biopsies were included in the study. The histological classification of these lesions was based on World Health Organization (WHO). Results: Out of total 108 biopsies, 79 were non-neoplastic lesions, 26 were neoplastic lesions & 3 were inadequate biopsies for accurate interpretation. Most patients presented in the age group of 21-30 years with a male to female ratio of 1.76:1. The most common presenting complaint for both non-neoplastic & neoplastic lesions was diarrhoea. Of all the lesions maximum were non-neoplastic lesions, among which chronic non-specific colitis was commonest. In the neoplastic lesions, classical adenocarcinoma was the commonest subtype encountered. Interpretation & Conclusion: Majority of the lesions of colon and rectum were non-neoplastic & comprised of chronic non-specific colitis, acute on chronic non-specific colitis, ulcerative colitis, tuberculosis, Hirschsprung’s disease, proctocolitis&proctitis. All these were more common in males & in the age group of 21-30 years and commonly presented with diarrhoea.The most common neoplasm was classical adenocarcinoma, which was found in patients above 40 years of age. There were two cases each of mucin secreting adenocarcinoma & signet ring cell carcinoma, which were seen in patients below 40 years of age.