RESUMEN
To investigate the alterations in these oligosaccharide side chains in gall bladder epithelial cells by histochemical techniques to shed further light in elucidating the development of gall stones and gall bladder neoplasia. The study was conducted on 35 cholecystectomies performed over a period of 3 months started from September[1st] 2008 to December[1st] 2008 in the laparoscopic unit in Al-Jomhori Teaching hospital in western side of Mosul city in northern Iraq. Clinical details and pathological data were retrieved from the records. The cholecystectomy specimens that were received were fixed in 10% formalin. The gall bladders were classified into two groups [calculus and acalculus]. Multiple sections were taken from each gall bladder [body, neck, and fundus] for paraffin blocks and were examined after staining with hematoxylin and eosin [H and E] in the Laboratory of Postgraduate Studies at the Department of Anatomy, Histology and Embryology in Mosul College of Medicine. Microscopic examination was done to assess the type of different lesions including inflammatory infiltrate, presence of fibrosis, cholesterolosis, metaplasia, dysplasia, tumor or tumor-like lesion. To evaluate the intra-epithelial mucin content multiple sections were processed and stained with Alcian blue [AB] /Periodic acid Schiff's stain [PAS]. The histochemical analysis of mucin of the sections which showed normal gallbladder mucosa revealed that most of the cells of normal gallbladder epithelium exhibiting positive PAS reaction indicating the presence of neutral mucins, while the acidic mucins showed weak reaction by alcian blue but brown color staining were not observed indicating the absence of sulfomucins. Histochemical analysis of mucin of the stone-containing gallbladder epithelium which showed different histological findings including inflammatory infiltrate, presence of fibrosis, cholesterolosis, and Rokitansky-Aschoff sinuses, revealed that the intense blue staining of sialomucins along with the very weak staining intensity of neutral mucins in goblet cells was observed by PAS-AB at pH 2.5 with strong intensity of Sulfomucins with as shown by the brown staining of alcian blue at pH 1.0. Histochemical alteration of mucin in the cases of adenoma of the gall bladder revealed that the intense blue staining of sialomucins with the weak staining intensity of neutral mucins in goblet cells was observed by PAS-AB at pH 2.5 with strong reaction of sulfomucins. On the other hand, intense blue staining of sialomucins along with the moderate staining intensity of neutral mucins was observed in section which showed dysplastic changes and in those which was diagnosed as carcinoma of the gall bladder. This study concluded that the sulfomucins and then the sialomucins may have a greater role in gall stone formation than the neutral mucins