Colonoscopy and Microscopy: Two sides of the coin- Our experience at Tertiary Care Centre in Central India

Introduction: The colonoscopy along with mucosal biopsy interpretation forms a prime diagnostic tool in work of patients with lesional diversity of colorectal region. The study was conduted to evaluate the histomorphological spectrum of colorectal lesions on colonoscopic biopsies and correlate the microscopy (histomorphology) with colonoscopic diagnosis offered. Materials and Methods: The material consisted of 168 colonoscopic biopsies which were submitted to the Department of Pathology, Govt. Medical College & Superspeciality Hospital, Nagpur during the period of Jan 2014 –Dec 2016. The histopathological classification of these lesions was based on WHO. Statistical analysis was done by Open Epi Info software. Result: Out of 168 colonoscopicbiopsies, 116 were non-neoplastic and 52 were neoplastic. A higher frequency of colonic diseases occur in males with male: female ratio -1.4:1 and the age range was between 2yrs to 92 yrs. Among the non-neoplastic lesions, ulcerative colitis was most common diagnosis, with frequent age group involved was 41- 50 yrs. Uncommon but interesting lesions like amoebic colitis (2 cases), pseudo membranous colitis(1 case), Melanosis coli (1 case) & congestive colopathy (1 case) were also found. Hyper plastic polyp & retention polyps were most common in non-neoplastic category while villous adenoma with dysplasia's was most common in neoplastic polyps. Among the neoplastic lesions, conventional adenocarcinoma was the commonest subtype with rectum as the most common site. Conclusion: Colonoscopy & Microscopy are the two sides of the coin which can be used effectively together not only in diagnosis &treatment of colorectal lesions but alsosurveillance of inflammatory bowel disease. As 48% of overall malignant lesions occurred in less than 50yrs of age, due importance should be given to colonoscopic screening to detect early colorectal neoplasm.