Background: The colon is a seat for various diseases which include both non neoplastic and neoplastic conditions. However, due to considerable overlap in clinical manifestations in the colonic lesions further investigations are crucial in determining underlying pathology. With the advent of flexible fibre optic sigmoidoscopy and colonoscopy adequately sampled biopsies facilitate documenting normal colonic mucosa, identifying inflammatory processes, discriminating different inflammatory reaction patterns, suggesting the possibility of more than one disease process and also, at times, identifying a specific causative agent.

Materials and Methods: All colonoscopic biopsies received in Department of Pathology in a tertiary care hospital in southern India during the two-year study period.

Results: Total of 98 colonoscopic biopsies were studied with a male to female ratio of 2.3: 1. Most common clinical presentation for both benign as well as malignant lesions was bleeding per rectum. Out of the colonoscopic biopsies, 45 (45.9%) were non neoplastic, 8 (8.16%) were benign lesions and 35 (35.78%) were malignant lesions. Among the 45 Non neoplastic lesions, 22 cases (48.8%) were non-specific colitis, 17 (37.7%) cases ulcerative colitis, 3 cases (6.66%) granulomatous inflammation, 2 cases (4.44%) inflammatory polyps and 1 case (2.22%)of juvenile polyp. Out of the 8 benign cases, 4 cases (50%) of tubulovillous adenoma, 3 cases (37.5%) of tubular adenomas, 1 case villous adenoma (12.5%). Out of 35 malignant lesions, 4 cases (11.4%) were Well Differentiated Adenocarcinoma, 24 cases (68.5%) were Moderately Differentiated Adenocarcinoma, 5 cases (14.2%) were Poorly Differentiated Adenocarcinoma, 1 case (2.8%) each of Mucin Secreting Adenocarcinoma and Malignant Melanoma.

Conclusion: Though clinical features supplemented with colonoscopy serve as an adequate tool to diagnose colonic pathology, histopathology remains the gold standard for definitive diagnosis.

Keywords: Colonoscopy, Colitis, Colorectal carcinoma, IBD, Adenoma.

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Dr Samrudhi Samant

Asst Professor, Dept of Pathology, 5 Air Force Hospital, Assam, India