Surgeons Throw Pathologist Catch – A Spectrum of Histomorphological Patterns in Gall Bladder Lesions
Authors/Creators
- 1. Associate Professor, Department of Pathology, IGGMCH, Nagpur
- 2. Associate Professor, Department of Pathology, GMCH, Nagpur
- 3. Assistant Professor, Department of Pathology, IGGMCH, Nagpur
- 4. Senior Resident, Department of Pathology, IGGMCH, Nagpur
- 5. Professor and HOD, Department of Pathology IGGMCH, Nagpur
Description
Background: Gall bladder lesions are remaining exceedingly ubiquitous and often needs surgical intervention. The histopathological patterns represent a spectrum, ranging from cholecystitis to gallbladder carcinoma. Histopathological analysis provide definitive diagnosis on resected specimen and hence ultimately help in further future management. Amongst all lesions cholecystitis with Cholelithiasis is known to produce diverse histopathological changes in the gallbladder mucosa. The present study aims to define the occurrence of various gallbladder lesions on histology. Method: This was a prospective observational study conducted in the Department of Pathology at Teaching Institute in Central India. The study period was two year, from first January 2021 to 31st December 2022. A total of 185 patients who underwent cholecystectomy at the institute were included in the study. Gross features of cholecystectomy specimens were recorded. Three sections each from the neck, body, and fundus were taken. Histopathological diagnosis was correlated with demographic data. Results: Total 185 patients were included, out of which 130 were females and 55 were males, with the mean age 45 years. 180 cases associated with different types of gall stones. The most common histopathological findings were chronic cholecystitis, observed in 164 patients i.e. 88.64% followed by adenocarcinoma of gall bladder 9 patients, 7 patients with acute cholecystitis, 3 patients having xanthogranulomatous cholecystitis. Conclusion: Diseases of the gallbladder often mandate prompt surgical intervention. Chronic cholecystitis, which is an established risk factor for gallbladder carcinoma, is one of the commonest presentations. Therefore detailed and meticulous histopathological examination remains crucial in the detection of premalignant and malignant lesions.
Abstract (English)
Background: Gall bladder lesions are remaining exceedingly ubiquitous and often needs surgical intervention. The histopathological patterns represent a spectrum, ranging from cholecystitis to gallbladder carcinoma. Histopathological analysis provide definitive diagnosis on resected specimen and hence ultimately help in further future management. Amongst all lesions cholecystitis with Cholelithiasis is known to produce diverse histopathological changes in the gallbladder mucosa. The present study aims to define the occurrence of various gallbladder lesions on histology. Method: This was a prospective observational study conducted in the Department of Pathology at Teaching Institute in Central India. The study period was two year, from first January 2021 to 31st December 2022. A total of 185 patients who underwent cholecystectomy at the institute were included in the study. Gross features of cholecystectomy specimens were recorded. Three sections each from the neck, body, and fundus were taken. Histopathological diagnosis was correlated with demographic data. Results: Total 185 patients were included, out of which 130 were females and 55 were males, with the mean age 45 years. 180 cases associated with different types of gall stones. The most common histopathological findings were chronic cholecystitis, observed in 164 patients i.e. 88.64% followed by adenocarcinoma of gall bladder 9 patients, 7 patients with acute cholecystitis, 3 patients having xanthogranulomatous cholecystitis. Conclusion: Diseases of the gallbladder often mandate prompt surgical intervention. Chronic cholecystitis, which is an established risk factor for gallbladder carcinoma, is one of the commonest presentations. Therefore detailed and meticulous histopathological examination remains crucial in the detection of premalignant and malignant lesions.
Files
IJPCR,Vol16,Issue2,Article226.pdf
Files
(3.2 MB)
| Name | Size | Download all |
|---|---|---|
|
md5:2952debe06a1f69279e7777f6aaf4b15
|
3.2 MB | Preview Download |
Additional details
Dates
- Accepted
-
2024-01-26
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue2,Article226.pdf
- Development Status
- Active
References
- 1. Jokhi CD, Kanetkar SR, Vohra VN. Study of histopathological findings in gallbladder diseases. Indian J Pathol Oncol. 2019; 6(4):627- 635. 2. Wang L, Chen J, Jiang W, Cen L, Pan J, Yu C, Li Y, Chen W, Chen C, Shen Z. The Relationship between Helicobacter pylori Infection of the Gallbladder and Chronic Cholecystitis and Cholelithiasis: A Systematic Review and Meta-Analysis. Can J Gastroenterol Hepatol. 2021 Jan 6; 2021:8886085. 3. Agostino DC, Wang DQ, Portincasa P An update on the pathogenesis of cholesterol gallstone disease.Curr Opin Gastroenterol. 2018 March; 34(2):71–80. 4. Talreja V, Ali A, Khawaja R, Rani K, Samnani SS, Farid FN. Surgically Resected Gall Bladder: Is Histopathology Needed for All? Surg Res Pract. 2016; 2016:9319147. 5. Stinton LM, Shaffer EA. Epidemiology of gallbladder disease: cholelithiasis and cancer. Gut Liver. 2012 Apr; 6(2):172-87. 6. Kalita D, Pant L, Singh S, Jain G, Kudesia M, Gupta K, Kaur C. Impact of routine histopathological examination of gall bladder specimens on early detection of malignancy - a study of 4,115 cholecystectomy specimens. Asian Pac J Cancer Prev. 2013; 14(5):3315-8. 7. Khan S, Rashikh MA, Rehman KU, Berjis H. Selective or Routine Histology of Cholecystectomy Specimens for Diagnosing Incidental Carcinoma of Gallbladder and Correlation with Careful Intraoperative Macroscopic Examination? A Systematic Review. Asian Pac J Cancer Prev. 2021 Mar 1; 22(3):651-659. 8. Kulkarni AM, Jadhav ED, Ramteke RV. Histopathological spectrum of gall bladder lesions. Int J Res Med Sci. 2020; 8:1056-60. 9. Damor NT, Chauhan HM, Jadav HR. Histological study of human gallbladder. Int J Biomed Adv Res. 2013; 4(09):597–601. 10. Shaffer EA. Gallbladder cancer: the basics. Gastroenterol Hepatol. 2008 Oct; 4(10):737- 41. 11. Dutta U, Bush N, Kalsi D, Popli P, Kapoor VK. Epidemiology of gallbladder cancer in India. Chin Clin Oncol. 2019 Aug; 8(4):33. 12. Song X, Hu Y, Li Y, Shao R, Liu F, Liu Y. Overview of current targeted therapy in gallbladder cancer. Signal Transduct Target Ther. 2020 Oct 7;5(1):230. 13. Dincel O, Goksu M, Hatipoglu HS. Importance of routine histopathological examination of a gallbladder surgical specimen: unexpected gallbladder cancer. J Cancer Res Ther. 2018; 14(6):1325–9. 14. Rammohan A, Cherukuri SD, Sathyanesan J, Palaniappan R, Govindan M. Xanthogranulomatous cholecystitis masquerading as gallbladder cancer: can it be diagnosed preoperatively? Gastroenterol Res Pract 2014;253645. 15. Singh VP, Rajesh S, Bihari C, Desai SN, Pargewar SS, Arora A. Xanthogranulomatous cholecystitis: What every radiologist should know. World J Radiol 2016; 8(2): 183-191 16. Ajani MA, Onakpoma FA, Fatunla EO, Adegoke OO, Salami AA. A Histomorphological Pattern of Gallbladder Lesions in a Tertiary Hospital in Southwestern Nigeria:A Retrospective Descriptive Study. Rwanda Medical Journal. 2021; 78(1): 47-51. 17. Khan S, Jetley S, Husain M. Spectrum of histopathological lesions in cholecystectomy specimens: A study of 360 cases at a teaching hospital in South Delhi. Arch Int Surg 2013; 3:102-5. 18. Benkhadoura M, Elshaikhy A, Eldruki S, Elfaedy O. Routine histopathological examination of gallbladder specimens after cholecystectomy: Is it time to change the current practice? Turk J Surg 2019; 35 (2): 86-90. 19. Srinivas GN, Sinha S, Ryley N, Houghton PW. Perfidious gallbladders - a diagnostic dilemma with xanthogranulomatous cholecystitis. Ann R Coll Surg Engl 2007; 89: 168-172. 20. Halldestam I, Enell E.-L., Kullman E., Borch K. Development of symptoms and complications in individuals with asymptomatic gallstones. British Journal of Surgery. 2004; 91(6):734–738.