Gastrointestinal, Liver and Biliary Tract Pathology: A Histopathological and Epidemiological Perspective from Pakistan with a Review of the Literature


Aim: To present an epidemiological and histological perspective of diseases of the gastrointestinal tract(including liver and biliary tract) at the Section of Histopathology, Department of Pathology, AKUH, Karachi,Pakistan. Materials and
Methods: All consecutive endoscopic biopsies and resections between October 1 andDecember 31, 2012 were included.
Results: A total of 2,323 cases were included. Carcinoma was overwhelminglythe commonest diagnosis on esophageal biopsies (69.1%); chronic helicobacter gastritis (45.6%) followed byadenocarcinoma (23.5%) were the commonest diagnoses on gastric biopsies; adenocarcinoma (27.3%) followed byulcerative colitis (13.1%) were the commonest diagnoses on colonic biopsies; acute appendicitis (59.1%) was thecommonest diagnosis on appendicectomy specimens; chronic viral hepatitis (44.8%) followed by hepatocellularcarcinoma (23.4%) were the commonest diagnoses on liver biopsies; chronic cholecystitis was the commonestdiagnosis (over 89%) on cholecystectomy specimens.
Conclusions: Squamous cell carcinoma comprised 88.8%of esophageal cancers. About 67% were in the lower third and 56.5% were moderately differentiated; mean ages49.8 years for females and 55.8 years for males; 66% cases were from South West Pakistan. Over 67% patientswith gastric adenocarcinoma were males; mean ages 59 and 44 years in males and females respectively, about74% gastric carcinomas were poorly differentiated; and 62.2% were located in the antropyloric region. About63% patients with colorectal adenocarcinoma were males; mean ages 46.1 and 50.5 years for males and femalesrespectively; tumor grade was moderately differentiated in 54%; over 80% were located in the left colon. In21.2% appendicectomies, no acute inflammation was found. Acute appendicitis was most common in youngpeople. Hepatitis C (66.3%) was more common than hepatitis B (33.7%); about 78% cases of hepatocellularcarcinoma occurred in males; females comprised 76.7% patients with chronic cholecystitis; and 77.8% patientswith gall bladder carcinoma. All resection specimens showed advanced cancers. Most cancers occurred afterthe age of 50 years.