A Histopathological Study of Neoplastic Lesions of Large Intestine

Background Large Intestinal Neoplasm is a common form of neoplasm in India and world. It is a leading cause of death. Carcinoma of the large bowel is the third most common cancer among men and women, and the second leading cause of death from cancer. Classifying large intestinal neoplasms according to its location and histological types along with its staging and grading are helpful in early diagnosis and therapeutic decisions, providing better outcome. Aims and objectives Study of histological evaluation with staging and grading of neoplastic lesions of large intestine. Material and method A study of 67 patients presenting with C/O abdominal pain and bleeding per rectum at B. J. M. C, Civil Hospital, Ahmedabad over a period of three years from 2014 to 2016. All specimens of resected intestine (large bowel) were received and overnight fixation in 10 % formalin was done. Gross examination findings were noted followed by routine paraffin embedding and tissue sectioning. Slides were stained using H& E stain, examined microscopically and grading/staging was done followed by comparison with other studies. Results In present study, out of 67 cases of neoplastic lesions of large intestine 51 cases (76.12 %) were of malignant nature. The commonest age group affected by neoplastic large intestinal lesions is 51-70 years with male female ratio of 21. Rectum (33/67) is the commonest site of involvement. While 10.4 % cases were of juvenile polyp (benign) among all neoplastic large intestinal lesions, adenocarcinoma (70.14 %) was the commonest malignant lesion. With respect to histological grading, the highest number of cases of adenocarcinoma of large intestine were of moderate differentiation (24/47) and DUKES STAGE C2 (19/35) is the most common stage of adenocarcinoma of large intestine. Other malignant lesions include basaloid carcinoma (1 case), GIST (2 cases) and malignant melanoma (1 case). Conclusion Majority of neoplastic intestinal lesions were of malignant nature distributed among the age group of 41-70 years with male preponderance. Polyps and adenocarcinoma are the commonest benign and malignant lesions of large intestine respectively. Classification of large intestinal neoplasms according to its location and histological types along with its staging and grading are helpful for therapeutic decisions providing better outcome.