Clinicopathological profile ofcholecystectomy specimens-aretrospective and prospective study
Keywords:
Adenocarcinoma, Cholecystitis, Gall bladder, Histopathology, Prevalence
Abstract
Objectives: To study the magnitude of lesions in gallbladder and to study different types of histopathological lesions occurring in the gallbladder and to co-relate them clinicopathologically.
Design and Methods: Cholecystectomy specimens received in Pathology department of our hospital for histopathological examination were included in this study. Patients age, sex, presenting symptoms, serum bilirubin levels and USG findings among others were noted. After gross examination minimum three sections one each from neck, fundus and body were given.The sections were subjected to routine paraffin processing and H&E staining.Special stains like PAS, Mucicarmine were performed whenever indicated.The sections were studied microscopically, and findings noted.
Results: Variety of lesions can be found if cholecystectomy specimens were examined meticulously.Patients usually present with signs and symptoms of long duration and with vague complaints like pain in abdomen, nausea, dyspepsia.Most of the cases seen were of chronic calculus cholecystitis. These cases were predominant in females and associated mostly with pigmented stones.All cases of carcinoma gallbladder were missed on clinical examination and ultrasonography.
Conclusion:Diagnosis was established on histopathology.Hence histopathology remains gold standard for revealing unsuspected lesions
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References
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40. Tyagi S, Tyagi N, Maheshwari V, Ashraf S, Sahoo P. Morphological changes in diseased gall bladder: A study of 415 cholecystectomies at Aligarh. Journal Of Indian Medical Association. 1992 Jul; 90(7):178-81.
41. Dabbs DJ. Eosinophilic and lymphoeosinophilic cholecystitis. Am J SurgPathol. 1993 May;17(5):497-501.[pubmed]
42. Merriam LT, Kanaan SA, Dawes LG, et al. Gangrenous cholecystitis: analysis of risk factors and experience with laparoscopic cholecystectomy. Surgery. 1999 Oct;126(4):680-5; discussion 685-6.[pubmed]
43. Kozuka S, Tsubone N, Yasui A, Hachisuka K.Relation of adenoma to carcinoma in the gallbladder. Cancer. 1982 Nov 15;50(10):2226-34.[pubmed]
44. Albores-Saavedra J, Alcántra-Vazquez A, Cruz-Ortiz H, et al. The precursor lesions of invasive gallbladder carcinoma. Hyperplasia, atypical hyperplasia and carcinoma in situ. Cancer. 1980 Mar 1;45(5):919-27.[pubmed]
45. Zahrani IH, Mansoor I. Gallbladder pathologies and cholelithiasis. Saudi Med J. 2001 Oct;22(10):885-9.[pubmed]
46. Joon J, Misron N.A clinicopathological study of nine cases of gallbladder carcinoma in 1122 cholecystectomies in Johor, Malaysia. Malaysian Journal of Pathology. 2008; 30(1): 21-26.
47. Perpetuo MD, Valdivieso M, Heilbrun LK, et al. Natural history study of gallbladder cancer: a review of 36 years experience at M. D. Anderson Hospital and Tumor Institute. Cancer. 1978 Jul;42(1):330-5.[pubmed]
48. Shieh C, Dunn E, Standard J. Primary carcinoma of the gallbladder: A review of a 16-year experience at the waterbury hospital health center. Cancer. 1981;47(5):996-1004.[pubmed]
49. Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the gallbladder. Histologic types, stage of disease, grade, and survival rates. Cancer. 1992 Sep 15;70(6):1493-7.[pubmed]
2. Crawford J, Liu C. Liver and Biliary Tract. Pathologic basis of disease. 8th ed: Elsevier; 2011.
3. Hart J, Modan B, Shani M. Cholelithiasis in the aetiology of gallbladder neoplasms. Lancet. 1971 Jun 5;1(7710):1151-3.[pubmed]
4. Khuroo MS, Mahajan R, Zargar SA, et al. Prevalence of biliary tract disease in India: a sonographic study in adult population in Kashmir. Gut. 1989 Feb;30(2):201-5.[pubmed]
5. Singh V, Trikha B, Nain C, et al. Epidemiology of gallstone disease in Chandigarh: a community-based study. J Gastroenterol Hepatol. 2001 May;16(5):560-3.[pubmed]
6. Marschall HU, Einarsson C. Gallstone disease. J Intern Med. 2007 Jun;261(6):529-42. DOI:10.1111/j.1365-2796.2007.01783.x[pubmed]
7. Johnston DE, Kaplan MM. Pathogenesis and treatment of gallstones. N Engl J Med. 1993 Feb 11;328(6):412-21. DOI:10.1056/NEJM199302113280608.[pubmed]
8. Kapoor VK, McMichael AJ. Gallbladder cancer: an 'Indian' disease. Natl Med J India. 2003 Jul-Aug;16(4):209-13.[pubmed]
9. Pal V, Lakhatia H, Gahlaur Y, Ghargav. A. Clinicopathological study of cholecystitis. Indian Journal Of Surgery. 1980 Sep;426-431.
10. Attili AF, De Santis A, Capri R, et al. The natural history of gallstones: the GREPCO experience. The GREPCO Group. Hepatology. 1995 Mar;21(3):655-60.[pubmed]
11. Mohan H, Punia P, Dhawan S, Ahal S. Morphological spectrum of gallstone disease in 1100 cholecytectomies in north India. Indian Journal of Surgery. 2005;67(3):140-142.
12. Mazlum M, Dilek FH, Yener AN, et al. Profile of gallbladder diseases diagnosed at AfyonKocatepe University: a retrospective study. Turk PatolojiDerg. 2011 Jan;27(1):23-30.[pubmed]
13. Singh A, Bagga SP, Jindal VP, et al. Gall bladder disease: an analytical report of 250 cases. J Indian Med Assoc. 1989 Nov;87(11):253-6.[pubmed]
14. Raza M, Khan M, Naim M. Gallstone disease-A clinicopathologic study. Indian Journal Surgery. 1990; 52(9):415-420.
15. Udwadia R. Surgery for gallstones: IS the heterodox of today the orthodox of tomorrow? Indian Journal Of Surgery. 1992; 54(10-11):465-474.
16. Chatterjee A, Banerjee P. Evaluation of cholecystitis in young patients-its incidence, etiology and treatment. Indian Journal of Surgery. 1989 Jul;51(7):293-295.
17. Kabra SK, Talati A, Shah R, et al. Acute acalculous cholecystitis. Indian Pediatr. 1991 Jul;28(7):803-6.[pubmed]
18. Cucchiaro G, Watters CR, Rossitch JC, Meyers WC. Deaths from gallstones. Incidence and associated clinical factors. Ann Surg. 1989 Feb;209(2):149-51.[pubmed]
19. Bekele Z, Tegegn K. Cholecystitis: the Ethiopian experience, a report of 712 operated cases from one of the referral hospitals. Ethiop Med J. 2002 Jul;40(3):209-16.[pubmed]
20.Kotwal MR, Rinchen CZ. Gallstone disease in the Himalayas (Sikkim and north Bengal): causation and stone analysis. Indian J Gastroenterol. 1998 Jul-Sep;17(3):87-9.[pubmed]
21. Khanna R, Chansuria R, Kumar M, Shukla HS. Histological changes in gallbladder due to stone disease. Indian Journal Of Surgery. 2006 Jul-Aug; 68(4):201-204.
22. Rahman GA. Cholelithiasis and cholecystitis: changing prevalence in an African community. Journal Of National Medical Association. 2005 Nov; 97 (11):1534-1538.
23. Meyer K, Capos N, Mittelpunkt A. Personal experience with 1261 cases of acute and chronic cholecystitis and cholelithiasis. .Surgery. 1967 May; 61(5):661-668.
24. Saxena R, Kumar P, Samujh R, Kaushik S, Yadav R. Spectrum of benign biliary disease as seen at Chandigarh. Indian Journal Of Surgery. 1991;53(8-9):347-356.
25. Bhansali S. Cholelithiasis and cholecystitis: an appraisal of clinico-surgical experiences with 228 cases.Journal of Post Graduate Medicine. 1980;26(1):74
26. Levy A, Murakata L. Rohrmann C. Gallbladder carcinoma: radiologic -pathologic correlation. AFIP ARCHIVES. 2001 Mar; 21(2):295-314.[pubmed]
27. Sugiyama M, Xie XY, Atomi Y, Saito M. Differential diagnosis of small polypoid lesions of the gallbladder: the value of endoscopic ultrasonography. Ann Surg. 1999 Apr;229(4):498-504.[pubmed]
28. Moriguchi H, Tazawa J, Hayashi Y, et al. Natural history of polypoid lesions in the gall bladder. Gut. 1996 Dec;39(6):860-2.[pubmed]
29. Friedman GD, Kannel WB, Dawber TR. The epidemiology of gallbladder disease: observations in the Framingham Study. J Chronic Dis. 1966 Mar;19(3):273-92.[pubmed]
30. Hussain A, Zargar H, Ahmed M, BhanB.Gallstone: a chemical study in Kashmir. Indian Journal Of Surgery. 1984 Mar; 3:156-161.
31. Ti TK, Wong CW, Yuen R, Karunanithy R. The chemical composition of gallstones: its relevance to surgeons in Southeast Asia. Ann Acad Med Singapore. 1996 Mar;25(2):255-8.[pubmed]
32. Jayanthi V, Palanivelu C, Prasanthi R, et al. Composition of gallstones in Coimbatore District of Tamil Nadu State. Indian J Gastroenterol. 1998 Oct-Dec;17(4):134-5.[pubmed]
33. Pavlidis T, Lazaridis C, Atmatzidis K, Makris J, Papaziogas B, Papaziogas T. Gallbladder specimen pathology for presumed gallstone disease. HPB. 2000;2(1):33-37.
34. Barcia JJ. Histologic analysis of chronic inflammatory patterns in the gallbladder: diagnostic criteria for reporting cholecystitis. Ann Diagn Pathol. 2003 Jun;7(3):147-53.[pubmed]
35. Dowling GP, Kelly JK. The histogenesis of adenocarcinoma of the gallbladder. Cancer. 1986 Oct 15;58(8):1702-8.[pubmed]
36. Roberts K, Parsons M. Xanthogranulomatous cholecystitis: clinicopathological study of 13 cases. Journal of Clinical Pathology. 1987;40(4):412-417.
37. Karabulut Z, Besim H, Hamamci O, Bostanoglu S, Korkmaz A. Xanthogranulomatous Cholecystitis. Retrospective Analysis of 12 Cases. Acta ChirurgicaBelgica. 2003;103(3):297-299.
38. Guzmán-Valdivia G. Xanthogranulomatous cholecystitis: 15 years' experience. World J Surg. 2004 Mar;28(3):254-7. Epub 2004 Feb 17. DOI:10.1007/s00268-003-7161-y.[pubmed]
39. Meirelles-Costa A, Bresciani C, Perez R, Bresciani B, Siqueira S, Cecconello I. Are histological alterations observed in the gallbladder precancerous lesions?. Clinics. 2010;65(2).
40. Tyagi S, Tyagi N, Maheshwari V, Ashraf S, Sahoo P. Morphological changes in diseased gall bladder: A study of 415 cholecystectomies at Aligarh. Journal Of Indian Medical Association. 1992 Jul; 90(7):178-81.
41. Dabbs DJ. Eosinophilic and lymphoeosinophilic cholecystitis. Am J SurgPathol. 1993 May;17(5):497-501.[pubmed]
42. Merriam LT, Kanaan SA, Dawes LG, et al. Gangrenous cholecystitis: analysis of risk factors and experience with laparoscopic cholecystectomy. Surgery. 1999 Oct;126(4):680-5; discussion 685-6.[pubmed]
43. Kozuka S, Tsubone N, Yasui A, Hachisuka K.Relation of adenoma to carcinoma in the gallbladder. Cancer. 1982 Nov 15;50(10):2226-34.[pubmed]
44. Albores-Saavedra J, Alcántra-Vazquez A, Cruz-Ortiz H, et al. The precursor lesions of invasive gallbladder carcinoma. Hyperplasia, atypical hyperplasia and carcinoma in situ. Cancer. 1980 Mar 1;45(5):919-27.[pubmed]
45. Zahrani IH, Mansoor I. Gallbladder pathologies and cholelithiasis. Saudi Med J. 2001 Oct;22(10):885-9.[pubmed]
46. Joon J, Misron N.A clinicopathological study of nine cases of gallbladder carcinoma in 1122 cholecystectomies in Johor, Malaysia. Malaysian Journal of Pathology. 2008; 30(1): 21-26.
47. Perpetuo MD, Valdivieso M, Heilbrun LK, et al. Natural history study of gallbladder cancer: a review of 36 years experience at M. D. Anderson Hospital and Tumor Institute. Cancer. 1978 Jul;42(1):330-5.[pubmed]
48. Shieh C, Dunn E, Standard J. Primary carcinoma of the gallbladder: A review of a 16-year experience at the waterbury hospital health center. Cancer. 1981;47(5):996-1004.[pubmed]
49. Henson DE, Albores-Saavedra J, Corle D. Carcinoma of the gallbladder. Histologic types, stage of disease, grade, and survival rates. Cancer. 1992 Sep 15;70(6):1493-7.[pubmed]
CITATION
DOI: 10.17511/jopm.2018.i06.07
Published: 2018-10-31
How to Cite
Dr. Vinod Ramesh Mahajan, Dr. Ashish Vilas Jawarkar, & Dr. B N Hiwale,Professor. (2018). Clinicopathological profile ofcholecystectomy specimens-aretrospective and prospective study. Tropical Journal of Pathology and Microbiology, 4(6), 455-465. https://doi.org/10.17511/jopm.2018.i06.07
Section
Original Article
OAI - Open Archives Initiative
