UPPER GASTROINTESTINAL ENDOSCOPIC BIOPSY

MORPHOLOGICAL SPECTRUM OF LESIONS

Abstract

Background: Upper GI endoscopy is an established procedure for investigating
a wide range of upper GI conditions especially inflammatory and malignant diseases of
stomach and esophagus. A good correlation in diagnosis can be achieved by complementing
endoscopic findings with histology of biopsy specimens. Aims and objectives: 1) To evaluate
morphological patterns of upper GI conditions. 2) To correlate endoscopic characterization of
upper GI lesions with histopathological assessment of biopsy specimens. Study design: A
retrospective descriptive study. Period: Four year period from January 2010 to December 2013.
Setting: Department of Pathology, LUMHS and were histologically assessed. Material and
methods: A total of 433 upper GI endoscopic biopsies were received. Patient’s age, gender and
presenting complaints were noted. Results: Stomach was the most frequent site of endoscopic
biopsy (51.3%) followed by esophagus (39%) and duodenum (9.7%). Majority of patients (51%)
presented with dysphagia and abdominal pain. Mean age of presentation was 40 years; age
range, 9-90 years and male: female ratio is 1:1.6. Esophageal malignancy was the commonest
neoplastic lesion with squamous cell carcinoma being the dominant histological type.
Interestingly, inflammatory conditions were more common in the stomach. In the duodenum,
celiac disease was clinically suspected and histopathological grading confirmed the diagnosis
with majority of the cases showing grade-II pathology. Conclusion: This large retrospective
institutional based study showed a good correlation between endoscopic and histological
diagnosis. It further shows that esophagus is the predominant site of upper GI malignancy with
strong female predominance. Further studies are needed to identify the underlying risk factors.