HISTOPATHOLOGICAL SPECTRUM OF GASTROINTESTINAL LESIONS: CORRELATING BIOPSY WITH ENDOSCOPY FINDINGS
DOI:
https://doi.org/10.22159/ijcpr.2025v17i6.7098Keywords:
Biopsy, Colon, Endoscopy, Gastrointestinal, Histopathology, Inflammation, LesionsAbstract
Objective: To assess the spectrum of histopathological findings in gastrointestinal (GI) lesions and correlate them with endoscopic impressions to evaluate diagnostic accuracy and concordance.
Methods: This retrospective observational study was conducted in the Department of Pathology at a tertiary care center from January 2021 to March 2024. A total of 76 endoscopic GI biopsy samples were analyzed after applying inclusion and exclusion criteria. Endoscopic features were documented from requisition forms and compared with corresponding histopathological diagnoses. Sensitivity, specificity, predictive values, and diagnostic concordance were calculated, and statistical analysis was performed using the Chi-square test and Cohen’s Kappa.
Results: Out of 76 cases, 55 (72.3%) were non-neoplastic and 21 (27.6%) were neoplastic. The most common non-neoplastic diagnosis was non-specific inflammation (38.2%), while carcinoma was the predominant neoplastic lesion (76.2% of neoplastic cases). Endoscopic growths were most predictive of malignancy, while mucosal changes and ulcerations were often associated with benign conditions. Endoscopy showed a sensitivity of 80.9%, specificity of 72.7%, and diagnostic accuracy of 75% in identifying neoplastic lesions. The concordance rate between endoscopic and histopathological findings was 67%, with a Cohen’s Kappa value of 0.67, indicating substantial agreement.
Conclusion: Endoscopy remains a valuable initial diagnostic tool, but histopathological confirmation is essential, especially for distinguishing benign from malignant GI lesions. This study highlights the importance of integrating both modalities to improve diagnostic confidence and guide appropriate clinical management.
Downloads
References
1. Krishnappa R, Horakerappa M, Ali K, Gouri M. A study on histopathological spectrum of upper gastrointestinal tract endoscopic biopsies. Int J Med Res Health Sci. 2013;2(3):418-24. doi: 10.5958/j.2319-5886.2.3.073.
2. Pailoor K, Sarpangala MK, Naik RC. Histopathological diagnosis of gastric biopsies in correlation with endoscopy a study in a Tertiary Care Center. Adv Lab Med Int. 2013;3(2):22-31.
3. Isaacson P. Biopsy appearances easily mistaken for malignancy in gastrointestinal endoscopy. Histopathology. 1982 Jul;6(4):377-89. doi: 10.1111/j.1365-2559.1982.tb02735.x, PMID 7118078.
4. Deutsch JC. The optical biopsy of small gastric lesions. Gastrointest Endosc. 2014;79(1):64-5. doi: 10.1016/j.gie.2013.07.035, PMID 24342587.
5. Rauta S, Baisakh P, Sahoo AK, Panda DK, Baisakh MR, Dash SS. Correlation of endoscopic and histopathological diagnoses in upper gastrointestinal tract lesions: a cross-sectional study. Cureus. 2024 Sep 16;16(9):e69553. doi: 10.7759/cureus.69553, PMID 39421087, PMCID PMC11484197.
6. Saroha N, Ahamed MA. Histopathological study of neoplastic lesions of upper gastrointestinal tract endoscopic biopsies. Indian J Pathol Oncol. 2022;9(1):43-7. doi: 10.18231/j.ijpo.2022.010.
7. Rai NN, Agrawal MM. Histopathological spectrum of upper gastrointestinal lesions detected by endoscopy-guided biopsy-a single institute experience. IP Archives of Cytology and Histopathology Research. 2019;4(2):154-8. doi: 10.18231/j.achr.2019.029.
8. Sharma S, Kumari K, Sharad S, Shah G, Neelam. Histopathological spectrum of lesions in gastrointestinal endoscopic biopsy: a prospective study of 500 cases. Indian J Pathol Oncol. 2020;7(3):384-91. doi: 10.18231/j.ijpo.2020.077.
9. Rastogi G, Chawhan SM. Histopathology of endoscopic biopsies of gastrointestinal tract lesions with clinical correlation. Acta Med Int. 2023;10(2):79-90. doi: 10.4103/amit.amit_8_23.
10. Goel R, Bansal R, Jaiswal N. Clinico-histo-morphological spectrum of endoscopic biopsies of upper gastrointestinal tract. JK Sci J Med Educ Res. 2022;24(1):28-32.
11. Kaur M, Bhasin TS, Manjari M, Mannan R, Sharma S, Anand G. Correlation between histopathological and endoscopic findings of non-malignant gastrointestinal lesions: an experience of a Tertiary Care Teaching Hospital from Northern India. J Pathol Nep. 2018;8(1):1289-96. doi: 10.3126/jpn.v8i1.19456.
12. Margaret TJ, Lavanya M, Gerad RJ, Basha SK. Evaluating the spectrum of histomorphological patterns on endoscopic biopsy in patients with gastrointestinal tract disorders. Trop J Pathol Microbiol. 2020;6(1):12. doi: 10.17511/jopm.2020.i01.01.
13. Shanmugasamy K, Bhavani K, Anandraj Vaithy K, Narashiman R, Dhananjay SK. Clinical correlation of upper gastrointestinal endoscopic biopsies with histopathological findings and to study the histopathological profile of various neoplastic and non-neoplastic lesions. J Pharm Biomed Sci. 2016;6(4):220-4. doi: 10.20936/jpbms/160226.
14. Khandelia R, Saikia M. Histopathologic spectrum of upper gastrointestinal tract mucosal biopsies: a prospective study. IJMSCI. 2017;4(11):3314-6. doi: 10.18535/ijmsci/v4i11.11.
15. Sahu S, Suryakant WA, Jaiswal R. Endoscopic biopsies-a boon to diagnose gastrointestinal tract diseases. Int Arch Integr Med. 2019;6(12):47-56.
16. Kumawat DN, Shah DS, Goswami DH. A study of histopathological spectrum of gastrointestinal tract lesions in a Tertiary Care Centre. Int J Clin Diagn Pathol. 2021;4(2):9-12. doi: 10.33545/pathol.2021.v4.i2a.349.
17. Machiwal K, Menghani B, Kasliwal N, Sharma MP. Histopathological spectrum of lesions in gastrointestinal endoscopic biopsies in Jawahar Lal Nehru Medical College and associated group of Hospitals, Ajmer, Rajasthan. Int J Res Med Sci. 2022 Dec;10(12):2831-6. doi: 10.18203/2320-6012.ijrms20223084.
18. Kazi JI, Alam SM, Kazi AM, Anwar A, Shamsi Z. Correlation of endoscopic and histological diagnosis in upper gastrointestinal lesions. J Pak Med Assoc. 1990;40(12):281-3. PMID 2126566.
Published
How to Cite
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
