Gallbladder Mucosal Changes Associated with Chronic Cholecystitis and Their Relationship with Carcinoma Gallbladder.

ABSTRACT

384 cholecystectomy specimens were examined during a period of one year from Oct 2005 to Oct 2006, in the department of Pathology, ASCOMS, Sidhra. Jammu, for studying the histological patterns of chronic cholecystitis, the frequency of associated mucosal changes, the age related incidence and the relationship of carcinoma with various mucosal changes. Majority of patients presented in the fourth decade of life. The youngest patient was 16 years and the oldest 78 years of age. Acute and chronic inflammatory lesions were associated with ulceration in 13.02%, mucosal hyperplasia in 25.26% and antral metaplasia in 53.40%. Intestinal metaplasia constituted 9.11%, cholesterolosis was seen in 12.25%, dysplasia in 3.64% and neoplasia in 0.78% of cases. All the cases of carcinoma were associated with gallstones. Histological continuity between epithelial changes was seen in 35 cases. 8 cases had continuity of antral metaplasia, intestinal metaplasia and dysplasia. 2 cases showed continuity of intestinal metaplasia with dysplasia and carcinoma and 1 case showed continuity of dysplasia with carcinoma.It is inferred that antral metaplasia, intestinal metaplasia, dysplasia and carcinoma have an inter-relationship. There is a significant higher incidence of carcinoma gallbladder in patients who harbor gallstones for longer period. Histopathological examination is thus important in every case of cholecystectomy for identifying metaplasia, dysplasia and carcinoma.