Vol. 7, Issue 3, Part E (2024)

Introduction: Small intestine is the principal site for digestion and absorption of ingested food from the gastrointestinal tract. Nearly 75% of the total length of the gastrointestinal tract is made up by small intestine and it constitutes more than 90% of the mucosal surface area. The intestines are also the principal site where the immune system interfaces with a diverse spectrum of antigens present in food and gut microbes. Clinical and radiological findings are non-specific and histopathological study is required for the diagnosis. The significant rise in the incidence of these tumours is an important epidemiologic finding. Thus, the present study was conducted to find out the profiles of various histological lesions of the small intestine.

Materials and Methods: The present study was carried out in Histopathology, Department of Pathology, B.J. Medical college, Ahmedabad from period of March 2022 to June 2024, A total of 189 small intestine were studied.

Results: In the present study, total of 189 cases of small intestine were studied. The non-neoplastic lesions were more common in 1st and 3rd decade of life whereas malignant neoplastic lesions were seen in more number in age group 41-50 years and 51-60 years of age. The present study has reported 131 neoplastic cases, 4 benign cases, 6 cases suspicious for malignancy and 48 malignant cases and this concludes that among all lesions of small intestine, non-neoplastic lesions were 2.2 times more common than neoplastic lesions. Males were predominantly affected in both non-neoplastic as well as neoplastic (benign and malignant) lesions along with male: female ratio of 1.2:1. Abdominal pain was the commonest presenting symptom reported in the present study. The commonest site involved by non-neoplastic lesions of small intestine was Ileum whereas in neoplastic lesions, duodenum was the commonest site for malignant lesions and ileum for benign lesions. Out of all non-neoplastic intestinal lesions, inflammatory lesions constitute highest number of cases with chronic non-specific inflammation being the most common. Amongst malignant neoplastic lesions of small intestine, the commonest malignancy was Adenocarcinoma followed by GIST and lymphoma cases. Exophytic growth was the most common gross appearance of adenocarcinoma followed by full thickness infiltrative growth. Moderately differentiated adenocarcinoma (89.28%) was most common. Out of 28 resected cases of adenocarcinoma, 9 cases showed regional lymph node involvement. Non-neoplastic lesionswas more common in biopsy bit specimen than neoplastic lesions.

Conclusion: Histopathology is the gold standard technique in diagnostic algorithm for clinicians as it is a confirmatory method for final categorization and subcategorization of various non-neoplastic as well as neoplastic lesion. Histopathology is a very important part of staging and grading of various small intestinal malignancies which affects the treatment decision and prognosis as well.