A histopathological study of non-neoplastic gall bladder diseases with special reference to mucin histochemistry
Keywords:
Gall bladder, Cholecystitis, Cholesterolosis, Gall stones, Mucin histochemistry, PAS.
Abstract
Background: Cholelithiasis and even silent gallstones which are asymptomatic produce a series of epithelial pathological changes in gall bladder mucosa, which could be precursor lesions of gall bladder carcinoma.Aim: To study the non neoplastic gall bladder diseases with special reference to mucin histochemistry.Methods: Formalin-fixed paraffin-embedded surgically resected gallbladder tissue samples of last 5 years were sectioned. All sections were stained with Hematoxylin and Eosin, Alcian Blue (AB) at pH 2.5 and pH 1.0 and Periodic acid-Schiff's (PAS).Result: A total of 1420 cholecysteclomy cases were observed. Maximum cases were of chronic cholecystitis with gall stones 91.55 % (1300/1420) cases. The stones were mainly of mixed type 45.19% (474/1049) cases. Metaplasia was found in 182 out of 1420 cases. Mucin histochemistry in metaplstic group showed PAS positivity in all 182 cases, AB/PAS positivity at pH 2.5 in 97.25%(177/182) cases and AB/PAS positivity at pH 1 in 78.57%(143/182) cases.Conclusion: Cholelithiasis is the most important entity in gall bladder lesions and that there is a definite association between metaplasia-dysplasia-carcinoma sequence. Early detection of mucin histochemistry in metaplastic cases can lead to early diagnosis of carcinoma gallbladder.Keywords: Gall bladder, Cholecystitis, Cholesterolosis, Gall stones, Mucin histochemistry, PAS.References
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3. Gupta SC, Misra V, Singh PA, Anu Roy, Misra SP, Gupta AK. Gallstones and carcinoma gallbladder. Indian J Pathol Microbiol 2000;43(1):147-54.
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11. Mathur SK, Duhan A, Sunita S, Aggarwal M, Aggarwal G, Sen R, Sinsh S, Garg S. Correlation of gallstone characteristics with mucosal changes in gall bladder. Tropical gastroenterology 2012;33:39-44.
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15. Vahini G, Premalatha P, Mathi A, Krishna R, Renuka I.V. A Clinicopathological Study of Gallbladder Lesions. IOSR-JDMS 2015;14(2)III:15-20.
16. Terada T. Histopathologic features and frequency of gall bladder lesions in consecutive 540 cholecystectomies. Int J Clin Exp Pathol 2013;6(1):91-96
17. Mohan H, punia RP, dhawan SB, Ahal S, Sekhon MS. Morphological Spectrum of gall stone disease in 1100 cholecystectomies in North India. Indian J Surg.2005;67:140-142.
18. Duarte I, Llanos O, Domke H, Harz C, Valdivieso V. Metaplasia and precursor lesions of gallbladder carcinoma. Cancer 1993;72:1878-84.
19. Goyal S. Sharma S. Duhan A. Correlation between gallstones characteristics and gallbladder mucosal changes: A retrospective study of 313 patients. Clinical cancer Investigation Journal 2014:3(2):157-61.
20. Domeyer PJ, Sergentanis TN, Zagouri F, Tzilalts B, Mouzakioti E, Parasi A, et al. Chronic cholecystitis in elderly patients. Correlation of the severity of inflammation with the number and size of the stones. In Vivo 2008;22:269-72.
21. Smith BF, Lamont JT, Moore JRL, et al. Role of gall bladder mucin in pathophysiology of gall stones. The Journal of the American Medical Association 2008;4:51-56.
22. Shiffman ML, Sugerman HJ, Kellum HJ, Moore EW. Changes in gallbladder bile composition following gallstone formation and weight reduction.Gastroenterology 1992 Jul;103(1):214–1.
23. Shalin S, Ahlberg J, Einarsson K, Henriksson R, Danielson A. Quantitative ultrastructural studies of gallbladder epithelium in gallstones free subjects and patients with gall stones. Gut 1990 Jan;31(1):100–5.
24. Madrid JF, Hernandez F, Ballesta J. Characterisation of glycoproteins in the epithelial cells of human and other mammalian gallbladder. A Review. Pathol Int 1996 Apr;46:261–6.
25. Swobodnik W, Wenk H, Janowitz P, et al. Total biliary protein, mucus glycoproteins, cyclic-AMP and apolipoprotein in the gall bladder bile of patients with cholesterol stonesand stone-free controls. Scand J Gastroenterol 1991 Jul;26(7):771–8.
26. Hakkinen I, Laitio M. Epithelial glycoproteins of human gallbladder. Immunological characterization. Arch Pathol 1970 Aug;90(2):137–42.
27. Maki T, Matsushiro T, Suzuki N, Nakamura N. Role of sulphated glycoprotein in gallstone formation. Surg Gynecol Obstet 1971 May;132(5):846–54.
28. Lee SP. Hypersecretion of mucus glycoproteins by the gallbladder epithelium in experimental cholelithiasis. J Pathol 1981 Jul;134(3):199–207.
2. Zaki M, Al-Refeidi A. Histological changes in the Human Gallbladder Epithelium associated with gallstones. Oman Medical Journal 2009 Oct;24(4).
3. Gupta SC, Misra V, Singh PA, Anu Roy, Misra SP, Gupta AK. Gallstones and carcinoma gallbladder. Indian J Pathol Microbiol 2000;43(1):147-54.
4. Banerjee A, Tapadar A. Spectrum of histopathological changes in cholecystitis.Int J Biol Med Res 2015;6(1):4769-74
5. Mohan H, Punia RPS, Dhawan SB, Ahal S, Sekon MS. Morphological spectrum of gall stone in 1100 cholecystectomies in North India. Indian Jounal of surgery 2005;67:140-2.
6. Tyagi SP, Tyagi N, Maheshwari V, Ashraf SM, Sahoo P. Morphological changes in diseased gall bladder: A study of 415 cholecystectomies at Aligarh. Journal Indian Med Assoc 1992 Jul;90(7):178-81.
7. Selvi T.R, Sinha P, Subramaniam P.M, Konapur P.G, Prabha C.V. A clinicopathological study of cholecystitis with special reference to analysis of cholelithiasis. International Journal of Basic Medical Science 2011(4):68-72.
8. Pradhan SB, Joshi MR, Vaidya A. Prevalence of different types of gallstone in the patients with cholelithiasis at Kathmandu Medical College, Nepal. Kathmandu University Medical Journal 2009;27(7):268-71.
9. Tyagi SP, Tyagi N, Maheshwari V, Ashraf SM, Sahoo P. Morphological changes in diseased gall bladder: A study of 415 cholecystectomies at Aligarh. Journal Indian Med Assoc 1992 Jul;90(7):178-181.
10. Baig SJ, Biswas S, Das S, Basu K, Chattopadhyay G. Histopathological changes in gall bladder mucosa in cholelithiasis: correlation with chemical composition of gall stones. Trop Gastroenterol 2002;23(1):25-27.
11. Mathur SK, Duhan A, Sunita S, Aggarwal M, Aggarwal G, Sen R, Sinsh S, Garg S. Correlation of gallstone characteristics with mucosal changes in gall bladder. Tropical gastroenterology 2012;33:39-44.
12. Pradhan SB, Joshi MR, Vaidya A. Prevalence of different types of gallstone in the patients with cholelithiasis at Kathmandu Medical College, Nepal. Kathmandu University Medical Journal 2009;27(7):268-71.
13. Costa ALA, Bresciani CJ, Perez RO, Bresciani BH, Aparcedia S, Siqueira C, Cecconello I. Are histological alterations observed in the gall bladder precancerous lesions. CLINICS 2010;65(2):143-50.
14. Kaur A, Dubey V.K.,Mehta K.S.Gallbladder Mucosal Changes Associated with Chronic Cholecystitis and Their Relationship with Carcinoma Gallbladder. J.k science2012:14(2).
15. Vahini G, Premalatha P, Mathi A, Krishna R, Renuka I.V. A Clinicopathological Study of Gallbladder Lesions. IOSR-JDMS 2015;14(2)III:15-20.
16. Terada T. Histopathologic features and frequency of gall bladder lesions in consecutive 540 cholecystectomies. Int J Clin Exp Pathol 2013;6(1):91-96
17. Mohan H, punia RP, dhawan SB, Ahal S, Sekhon MS. Morphological Spectrum of gall stone disease in 1100 cholecystectomies in North India. Indian J Surg.2005;67:140-142.
18. Duarte I, Llanos O, Domke H, Harz C, Valdivieso V. Metaplasia and precursor lesions of gallbladder carcinoma. Cancer 1993;72:1878-84.
19. Goyal S. Sharma S. Duhan A. Correlation between gallstones characteristics and gallbladder mucosal changes: A retrospective study of 313 patients. Clinical cancer Investigation Journal 2014:3(2):157-61.
20. Domeyer PJ, Sergentanis TN, Zagouri F, Tzilalts B, Mouzakioti E, Parasi A, et al. Chronic cholecystitis in elderly patients. Correlation of the severity of inflammation with the number and size of the stones. In Vivo 2008;22:269-72.
21. Smith BF, Lamont JT, Moore JRL, et al. Role of gall bladder mucin in pathophysiology of gall stones. The Journal of the American Medical Association 2008;4:51-56.
22. Shiffman ML, Sugerman HJ, Kellum HJ, Moore EW. Changes in gallbladder bile composition following gallstone formation and weight reduction.Gastroenterology 1992 Jul;103(1):214–1.
23. Shalin S, Ahlberg J, Einarsson K, Henriksson R, Danielson A. Quantitative ultrastructural studies of gallbladder epithelium in gallstones free subjects and patients with gall stones. Gut 1990 Jan;31(1):100–5.
24. Madrid JF, Hernandez F, Ballesta J. Characterisation of glycoproteins in the epithelial cells of human and other mammalian gallbladder. A Review. Pathol Int 1996 Apr;46:261–6.
25. Swobodnik W, Wenk H, Janowitz P, et al. Total biliary protein, mucus glycoproteins, cyclic-AMP and apolipoprotein in the gall bladder bile of patients with cholesterol stonesand stone-free controls. Scand J Gastroenterol 1991 Jul;26(7):771–8.
26. Hakkinen I, Laitio M. Epithelial glycoproteins of human gallbladder. Immunological characterization. Arch Pathol 1970 Aug;90(2):137–42.
27. Maki T, Matsushiro T, Suzuki N, Nakamura N. Role of sulphated glycoprotein in gallstone formation. Surg Gynecol Obstet 1971 May;132(5):846–54.
28. Lee SP. Hypersecretion of mucus glycoproteins by the gallbladder epithelium in experimental cholelithiasis. J Pathol 1981 Jul;134(3):199–207.
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2016-06-01
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