Background: Esophageal lesions have a wide range of clinical and pathologic spectrum. Understanding the endoscopic and pathologic features of esophageal lesions is critical for detecting, differentiating, and managing them. Esophageal lesions incidence might be neoplastic or non-neoplastic.

Aim: The current study aims to assess the clinical, endoscopic and histopathological evaluation of Esophageal Lesions.

Materials and Methods: The current cross-sectional study was conducted on 102 esophageal lesions received at the Pathology Department of Gulab Devi Chest Hospital, Lahore for the period during June 2020 to May 2021. Endoscopy was used to obtain esophageal biopsies of either gender, regardless of their age. Each case was microscopically evaluated, and biopsy specimens were immediately secured in 10% buffered neutral formalin. Data analysis and collection was done in SPSS version 21.

Results: Out of 102 endoscopic esophageal biopsies referred to Pathology Department for histopathological evaluation,male and female prevalence were 68 (66.7%) and 34 (33.3%) respectively. The overall mean age was 53.24±6.73 with an age range from 21 to 80 years. Based on age, the patient’s biopsies were categorized into six groups. A higher prevalence of esophageal lesions was observed in 51-60 (36.3%) years followed by age group 61-70 years (23.5%). Of the 102 patient’s biopsies,66 (64.7%) biopsy revealed squamous cell carcinoma, squamous dysplasia cases were 12 (11.8%), squamous papilloma was seen in one (0.98%) case, Adenocarcinoma cases were 4 (3.9%), Barrett’s esophagus was 4 (3.9%), esophagitis was 11 (10.8%) and squamous epithelium only was present in 4 (3.9%) cases.

Conclusion: Esophageal cancer is the common digestive tract malignancy. Malignancy can be distinguished from non-neoplastic masses on endoscopy by their symptoms, appearanceand size. For an early esophageal disease diagnosis, endoscopy is a popular and developed inspection means which can identify Barrett’s esophagus and squamous dysplasia from malignant lesions,which can help in proper treatment and follow-up. Microscopic evaluation of lesions labeled as inflammatory on endoscopy can turn out to be malignant. This demonstrates the importance of microscopic examination as a confirmatory diagnostic tool. Accurate diagnosis can be carried out on microscopic examination with immunohistochemistry and histochemical stains.