The Rugged Journey of Microscopy to The Lower Gastrointestinal Tract

Abstract Introduction: The gastrointestinal tract (GIT) is an important location for an extensive range of lesions, including both neoplastic and non- neoplastic lesions. Globally, 15-25% of all cancers are GIT cancers. Determining the local extent of diseases, managing the patient, and assessing the prognosis depend on the pathological analysis of specimens, especially the resected specimens. Aim & Objective: To study the histopathological spectrum of lesions in the resected lower GIT specimens. Methods: A retrospective study was conducted on 325 cases in the Pathology Department, Sri Siddhartha Medical College and Hospital for a period of 2.5 years. All resected specimens of lower GIT lesions (from the insertion of ligament of Treitz to the anal canal) were considered and categorized as Neoplastic and Non-neoplastic. These cases were correlated with clinical diagnosis wherever available, then the spectrum of diseases were studied. Results: Out of 325 cases, neoplastic lesions constituted 6.2% (n=20) and non-neoplastic lesions constituted 93.8% (n=305). In neoplastic lesions, malignant lesions constituted 90% (n=18), out of which 77.8% (n=14) constituted of colon carcinoma, rectal carcinoma- 16.7% (n=03), jejunal neuroendocrine tumour- 5.6% (n=1). Benign lesions constituted 10% of neoplastic lesions (n=02), out of which 50% (n=1)-GIST and 50% (n=1)- jejunal lipoma. Out of 305 non-neoplastic lesions, appendicitis-93% (n=286), ileal lesions (inflammatory and ischaemic)-3.6% (n=11), colonic lesions (inflammatory and granulomatous)- 1.6% (n=5) and jejunal lesions (heterotopia) 0.7% (n=2). Conclusion: Histopathological Examination of specimens remain the gold standard in the diagnosis of unknown cause and also help in the management and the prognosis of the patient.