Histopathological Profile of Benign Colorectal Diseases in Al-Madinah Region of Saudi Arabia


Background: Patients with long-standing inflammatory bowel disease (IBD) have an increased risk ofdeveloping colorectal cancer (CRC). Colon cancer risk in IBD increases with longer duration and greateranatomic extent of colitis, the presence of primary sclerosing cholangitis, family history of CRC and degree ofinflammation of the bowel. This study aimed to characterize the histopathological pattern of benign colorectaldiseases among Saudi patients and to highlight age and gender variations of lesions as base line data for futurestudies to investigate the link between benign / IBD and colorectal cancers in the local population. Materialsand
Methods: The materials consisted of 684 biopsies, reported as benign (excluding malignancies and polyps)at the Department of Pathology, King Fahad Hospital, Madinah, Saudi Arabia from January 2006 to December2013. Data collected and entered in MS-Excel and were analyzed using SPSS-20.
Results: Of 684 colorectaltissues reviewed, 408 specimens (59.6%) were from male patients and 276 specimens (40.4%) were from femalesgiving a male: female ratio of 1.5:1. Age of the patients ranged from 4 to 75 years with a mean of 39.6 years.The most frequent histologic diagnosis was a chronic non specific proctocolitis followed by ulcerative colitis,accounting respectively for 52.6% and 31.7% of all cases. These were followed by Crohn’s disease 22 (3.2%),ischemic bowel disease 20 (2.9%), diverticular disease 14 (2%), eosinophilic colitis 12 (1.7%) and solitary rectalulcer 12 (1.7%). A minority of 21 patients (3.1%) were cases of acute nonspecific proctocolitis, schistosomiasis,tuberculosis, volvulus and pseudomembranous colitis.
Conclusions: These data show that although chronic nonspecific proctocolitis and ulcerative colitis were the dominant diagnoses, Crohn’s disease, ischemic bowel diseaseand diverticular disease also existed to a lesser extent and should be considered in the differential diagnosis ofbenign colorectal diseases. This study provides a base line data for future studies which would be taken up toinvestigate the link between benign / IBD and colorectal cancers in the local population.