title: Gastrointestinal, liver and biliary tract pathology: a histopathological and epidemiological perspective from Pakistan with a review of the literature.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  All consecutive endoscopic biopsies and resections between October 1 and December 31, 2012 were included.
  
  
  RESULTS
  A total of 2,323 cases were included. Carcinoma was overwhelmingly the commonest diagnosis on esophageal biopsies (69.1%); chronic helicobacter gastritis (45.6%) followed by adenocarcinoma (23.5%) were the commonest diagnoses on gastric biopsies; adenocarcinoma (27.3%) followed by ulcerative colitis (13.1%) were the commonest diagnoses on colonic biopsies; acute appendicitis (59.1%) was the commonest diagnosis on appendicectomy specimens; chronic viral hepatitis (44.8%) followed by hepatocellular carcinoma (23.4%) were the commonest diagnoses on liver biopsies; chronic cholecystitis was the commonest diagnosis (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 ages 49.8 years for females and 55.8 years for males; 66% cases were from South West Pakistan. Over 67% patients with gastric adenocarcinoma were males; mean ages 59 and 44 years in males and females respectively, about 74% gastric carcinomas were poorly differentiated; and 62.2% were located in the antropyloric region. About 63% patients with colorectal adenocarcinoma were males; mean ages 46.1 and 50.5 years for males and females respectively; tumor grade was moderately differentiated in 54%; over 80% were located in the left colon. In 21.2% appendicectomies, no acute inflammation was found. Acute appendicitis was most common in young people. Hepatitis C (66.3%) was more common than hepatitis B (33.7%); about 78% cases of hepatocellular carcinoma occurred in males; females comprised 76.7% patients with chronic cholecystitis; and 77.8% patients with gall bladder carcinoma. All resection specimens showed advanced cancers. Most cancers occurred after the age of 50 years.
authors.affiliation: Pathology and Microbiology, Histopathology, Aga Khan University Hospital, Karachi, Pakistan E-mail : zubair.ahmad@aku.edu.
authors.forename: Zubair
authors.initials: Z
authors.lastname: Ahmad
authors.forename: Huma
authors.initials: H
authors.lastname: Arshad
authors.forename: Saira
authors.initials: S
authors.lastname: Fatima
authors.forename: Romana
authors.initials: R
authors.lastname: Idrees
authors.forename: Nasir
authors.initials: N
authors.lastname: Ud-Din
authors.forename: Rashida
authors.initials: R
authors.lastname: Ahmed
authors.forename: Arsalan
authors.initials: A
authors.lastname: Ahmed
authors.forename: Aisha
authors.initials: A
authors.lastname: Memon
authors.forename: Khurram
authors.initials: K
authors.lastname: Minhas
authors.forename: Muhammad
authors.initials: M
authors.lastname: Arif
authors.forename: Samia
authors.initials: S
authors.lastname: Fatima
authors.forename: Saroona
authors.initials: S
authors.lastname: Haroon
authors.forename: Shahid
authors.initials: S
authors.lastname: Pervez
authors.forename: Sheema
authors.initials: S
authors.lastname: Hasan
authors.forename: Naila
authors.initials: N
authors.lastname: Kayani
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010154:Pakistan / Q000453:epidemiology; D011379:Prognosis; D055815:Young Adult