A Histopathological Study of Gastrointestinal Polyps in Tertiary Care Hospital, Nepal

Abstract

Introduction: Gastrointestinal polyps may be non-neoplastic or neoplastic lesions. They are mostly asymptomatic and are common in the colon but may occur anywhere in the gastrointestinal tract. Some polyps have an increased risk for malignancy, so it is important to determine the histologic type and characteristics for treatment. This study was undertaken to determine the histomorphological spectrum of polyps, their potential risk for malignancy, and frequency in our center.

Methods: This is a descriptive study which was carried out at Kathmandu Medical College Teaching Hospital for a period of three years from 1st January 2011 to 31st December 2013. A total of 67 polypectomy specimens were received and processed in the Pathology Department. Hematoxylin and Eosin stained slides were examined.

Results: 47 (70.1%) gastrointestinal polyps were non-neoplastic, 19 (28.3%) were neoplastic and 1 (1.6%) was an infarcted polyp. Most of the patients presented with rectal bleeding. The age of patients for non-neoplastic and neoplastic polyps ranged from 3-74 and 23-78 years, respectively. Amongst the non-neoplastic polyps, 21 (44.7%) were retention polyps, 14 (29.8%) were inflammatory polyps, 10 (21.3%) were hyperplastic polyps, 1 (2.1%) benign gastric polyp and 1 (2.1%) non-categorized polyp. The neoplastic polyps had 16 (84.1%) adenomatous polyps, 1 (5.3%) mixed polyp, 1 (5.3%) fundic gland polyp, and 1 (5.3%) moderately differentiated adenocarcinoma. 11 (68.8%) adenomatous polyps had mild dysplasia, 2 (12.5%) moderate dysplasia, and 3 (18.7%) severe dysplasia. Size of the non-neoplastic polyps ranged from 0.2-5.0 cm and size of neoplastic polyps ranged from 0.3-6.0 cm in diameter. Some patients presented with more than one polyp.

Conclusion: Polyps have a diverse histomorphology and there is a risk of malignancy in the adenomatous polyps so it is important to screen patients for treatment and cancer prevention.