A Histopathological Study of the Small Intestinal Lesions

摘要

Introduction: Frequently received specimens of small intestine are non neoplastic diseases like Crohn’s, ischemic enteritis, non-specific enteritis, tuberculosis and neoplastic diseases like adenomas and carcinomas. Clinical and radiological findings are non specific and histopathological study is required for the diagnosis.Aim: To study histomorphology of small intestinal lesions and analyze with respect to age, sex, anatomical site of occurrence and relative frequency.Materials and Methods: This study of 124 cases was undertaken in the Department of Pathology, JSS Medical College and Hospital, Mysuru, India, between 2009 to 2012. In addition to H and E, Immunohistochemistry and special stains were done in required cases.Results: Total 124 cases of small intestinal lesions including the periampullary lesions were studied. Of these, 71 cases (57.25%) were non neoplastic and 53 cases (42.75%) were neoplastic. Common age group was 5th-6th decade. A male preponderance was observed. Most common non neoplastic lesions were non-specific enteritis (52.11%) and enteric fever (40%). Amongst neoplastic lesions, total 45 (84.91%) cases were malignant comprising adenocarcinomas of the periampullary region (49.06%) and carcinoid tumours (11.32%). Benign lesions were adenomas. Rare cases like myeloid sarcoma, metastatic adenocarcinoma and metastatic malignant melanoma were observed.Conclusion: A greater awareness of various diseases affecting the small intestine and an understanding of the pathogenesis on the part of the pathologist is felt necessary for a better diagnosis. A detailed histopathological study of the small intestinal specimens should be done in constant correlation with the clinical and radiological findings for an accurate diagnosis.