A histopathological study of colorectal neoplasms in a tertiary care hospital

Abstract

A wide variety of lesions affect the colon, including neoplastic and non-neoplastic. The clinical diagnosis is usually delayed due to vague symptoms. Colorectal cancer is the 3rd most common tumor type worldwide, and one of the leading causes of cancer related deaths. Pathological examination of biopsy and resected specimens are of crucial for determining the extent of disease, patient management and prognosis assessment. Our aim is to study the histomorphology of various neoplastic lesions of colorectum, to evaluate the incidence, age and sex ratio and classify them in to benign and malignant tumors. A cross-sectional study for 2 years from 1st June 2016 to 31st May 2018 and total of 44 cases were evaluated. The material for study comprised of both resected specimens and biopsies of neoplastic lesions of colorectum received in department of Pathology in J. J. M Medical College were subjected for detailed examination including gross and histopathological findings. Out of 44 specimen received, 17(38.7%) were resected specimens and 27(61.3%) were biopsy specimens and the lesions were further classified in to benign and malignant with 34% and 66% respectively. Most common histological variant of malignant tumor was moderately differentiated adenocarcinoma, and most common benign tumor was juvenile polyp. The majority of patients are between 61-70 years. Females were most commonly affected. Malignant lesions are more common than benign lesions in the colon. Adenocarcinoma is the most common malignant lesions of colon in our study. Introduction The colon is the site for broad array of both neoplastic and non-neoplastic diseases, which at times may lead to serious complications. Colon is the most common site for gastrointestinal neoplasm in western population. Colorectal cancer is one of the common malignancy encountered worldwide and is considered to be leading cause of deaths due to cancer. Colorectal epithelial tumors constitute a major cause of both morbidity and mortality worldwide. Approximately 1.2 million new cases of colorectal adenocarcinoma, and 6,00,000 associated deaths, occur each year worldwide. Colorectal cancer incidence peaks at 60-70 years of age, with less than 20% of cases occurring before age 50. Colorectal cancer exhibits geographic differences which can be attributed to changes in lifestyle and dietary habits. Non dietary causes include genetic predilection. Both gross as well as histological type along with clinical data correlation helps in definitive histological typing of the tumor, which helps for appropriate treatment and further management of the patient. Polyps are most common in colorectal regions but may occur at other sites like esophagus, stomach and small intestine. Adenomatous type is the most common type of polyp. Juvenile polyp and hyperplastic polyp are other common types. Our aim is to study the histomorphological spectrum of various colorectal neoplasms, evaluate relative frequency and classify them in to benign and malignant tumors. Materials and Methods This is a 2 years from 1 June 2016 to 31 May 2018 in the Department of Pathology J. J. M. Medical College, Davangere. Colorectal neoplasms diagnosed on both resected specimens as well as biopsies were included in our study. All the specimens received were processed according to the standard protocols. Results During this 2 years study period, we received a total of 44 cases which includes 15 cases (34%) and 29 cases (66%) of benign and malignant tumors respectively, of which 17 (38.7%) of resected specimens and 27(61.3%) of biopsy specimens. (Graph 1). The age of the patient ranged from 2 to 80 years. Out of these 20(45.4%) were males and 24(54.6%) were females, with male to female ratio of 0.8: 1. (Table 1). Article Info Received: 7th February, 2019 Accepted: 27th March, 2019 Published Online: 9th August, 2019