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A histopathological overview of lesions of anal canal

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Author: 
Dr. Hiren Mundiya and Dr. Ruchira Wadhwa
Abstract: 

Background: A wide variety of lesions of anal canal commonly presenting with bleeding per rectum are increasing in incidence nowadays. While majority of them are of non-neoplastic in nature, diagnosis and treatment of neoplastic lesions are of paramount importance. Histo-pathological examination is helpful in categorization of lesions of anal canal along with staging and grading of malignant lesionsto improvise the therapeutic decisions.
Aims: to study distribution and prevalence of lesions of anal canal in the community and comparison with other studies.
Methods: A study of 171 patients presenting with C/O abdominal pain and bleeding per rectum at B.J. Medical College, Civil Hospital, Ahmedabad over a period of three years from 2014 to 2016 was undertaken. All specimens of resected intestine (anal canal) as well as small biopsies were received and over-night fixation in 10% formalin was done. Gross examination findings were noted followed by routine paraffin embedding and tissue sectioning. Slides were stained using H&E stain, examined microscopically and staging was done followed by comparison with other studies.
Results: In the present study, out of 171 cases of lesion of anal canal, 149(93%) cases were non-neoplastic while remaining 22(7%) are neoplastic. Major distribution of the lesions was seen in the age group of 30-50 years with male: female ratio of 7:1. The most common non neoplastic lesion of anal canal is anal fistula(62.5%). Among all neoplastic lesions, Fibro-epithelial polyps(33.34%) were the commonest benign lesions and squamous cell carcinoma(16.8%) was the commonest malignant lesion.
Conclusion: Prevalence of lesions of anal canal is increasing among males of middle age. In respect to rarity of neoplastic lesions, most of the lesions of anal canal are highly curable. Thus histopathology is useful in therapeutic decisions to provide better outcome.

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               Prof. Dr. ISMAIL YILDIRIM

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