[Epithelial changes in the anal canal associated with hemorrhoids, fissures and fistulas]

A retrospective study of 118 cases of haemorrhoids (77 cases), fissures (7 cases) and fistulas (34 cases) was done to demonstrate epithelial changes in each of the three microscopic components (transitional, rectal mucosa and keratinized squamous epithelium) of the anal canal. Histopathologically the three main lesion were metaplasia (16.9%), dysplasia (13.5%) and Koilocytotic changes (11.8%). On the other hand, the metaplastic lesion was found only on the rectal mucosa (100%), dysplasia was demonstrated on the rectal mucosa (9.8%) and on the transitional zone (21.5%). Finally koilocytosis was diagnosed only on the anal skin. The authors believe that the histopathology study (biopsy) is the best choice for the establishment of the preneoplastic lesions (dysplasia) in terms of an early detection of malignancy on the anal canal.