Spectrum of Lesions of Gall Bladder

Experience of Five Years at Tertiary Care Hospital

  • Milind Patil Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai Maharashtra, India.
  • Mangesh Machindra Londhe Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai 400022, Maharashtra, India
  • Sangeeta Margam Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai 400022, Maharashtra, India.
  • Javed Iqbal Lokmanya Tilak Municipal Medical College and Lokmanya Tilak Municipal General Hospital, Sion, Mumbai 400022, Maharashtra, India.
Keywords: Gall bladder lesions, cholelithiasis, cholecystitis, cholesterolosis, carcinoma gall bladder.

Abstract

Background : The histopathological spectrum of gallbladder lesions is extremely variable and its frequency in cholecystectomies is not clear. This spectrum varies from non- neoplastic lesions like cholecystitis, gall stones, cholesterolosis, hyperplasia to neoplastic disorders. As there is limited literature available especially from this part of India, the aim of this study is to find incidences of various lesions of gall bladder in a tertiary care hospital.  Methods:  Five years retrospective and prospective analysis of 1096 cholecystectomies was carried out. Relevant clinical details of patient were noted down. Cholecystectomy specimens were studied for gross and microscopic examination after fixation of specimen with 10% formalin and microscopically examining H& E slides.  Results:  Overall, 1096 cases of cholecystectomies were analysed which revealed female preponderance with peak incidence of non-neoplastic lesion in 4th decade and neoplastic lesions in 5th decade. Gall stones were seen in 52% of cases. Incidence of various lesions was chronic cholecystitis 93.1%, acute cholecystitis 2.91%, chronic follicular cholecystitis 0.72%, xanthogranulomatous cholecystitis 1.1%, cholesterolosis 0.46%, eosinophilic cholecystitis 0.18%, and carcinoma of gall bladder 1.1%.

References

1. Dattal DS, Kaushik R, Gulati A, Sharma VK. Morphological spectrum of gall bladder lesions and their correlation with cholelithiasis. Int J Res Med Sci 2017;5:840-6.
2. Shukla HS, Sirohi B, Behari A et al. ICMR consensus document for the management of gall bladder cancer. Indian Journal of Medical and Paediatric Oncology 2015; 36(2):79-84.
3. Siddiqui FG, Memon AA and Ahmad. Routine histopathology of gallbladder after elective cholecystectomy for gallstones: waste of resources or a justified act? BMC Surgery. 2013; 13:26.
4. Devi B, Shetty J, Bose V. Histopathological Spectrum of Diseases in Gallbladder. National Journal of Laboratory Medicine. 2017; 6(4): 6-9.
5. Goyal S, Singla S, Duhan A. Correlation between gallstones characteristics and gallbladder mucosal changes: A retrospective study of 313 patients. Clin Cancer Investig J. 2014;3:157-61.
6. Selvi T, Sinha P, Subramaniam PM, Konapur PG, Prabha CV.A clinicopathological study of cholecystitis with special reference to analysis of cholelithiasis. International Journal of Basic Medical Science 2011; 2(2):68-72.
7. Awasthi N. A retrospective histopathological study of cholecystectomies. Int J Health Allied Sci. 2015;4:203-06.
8. Memon W, Khanzada TW, Samad A, Kumar B. Histopathological spectrum of gallbladder specimen after cholecystectomy. Pak J Med Sci 2011; 27:533-56.
9. Nigam M, Ranwaka R, Nigam B, Singh M, Devpura T P. Prevalance of carcinoma in symptomatic gallstone disease-A study following cholecystectomy. JEMDS 2013;25(2):4554-58.
10. Narendra GN, Gautam K. A spectrum of benign gallbladder diseases and their laparoscopic management: An experience of 100 patients. IJHRMLP 2015; 1(2): 25-31.
11. Arathi N, Awasthi S, Kumar A. Pathological profile of 11cholecystectomies at a teritiary centre. Natl J Med Dent Res. 2013;2(1):28-38.
12. Estrado RL, Brown NM, James CE: Chronic follicular cholecytitis: radiological, pathological and surgical aspects.Br J Surg 1960; 48:205.
13. Mohan H, Punia RP S, Dhawan SB, Ahal S, Sekhon MS. Morphological spectrum of gallstone disease in 1100 cholecystectomies in North India Indian Journal of Surgery, 2005; 67(3), 140-142
14. Sharma,Basu, Agarwal, Mishra. Gall Bladder disease in Gorakhpur region. Indian Journal Of Gastroenterology 1985:4(4):123-124
15. Guzman-Valdivia G. Xanthogranulomatous cholecystitis: 15 years Experience. World Journal of Surgery. 2004; 28(3):254-257.
16. Dixit VK, Parakash A, Gupta A et al. Xanthogranulatous Cholecystitis. Digestive Diseases and sciences 1998;43 (5) :122-125
17. Fox H, Mainwaring AR: Eosinophillic infiltration of gall bladder. Gastroenterology 1972; 63:1049- 1052.
18. Dabbs DJ. Eosinophilic and lymphoesinophilic cholecystitis. Am J SurgPathol 1993; 17: 497-501.
19. Durate I, Llanos O, Domke H, Harz C, Valdivieso V. Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution and probability of detection in routine histologic samples. Cancer 1993;72:1878-84.
20. Akritidis N, Mantzios G, Pappas G. Gallbladder adenomyomatosis presenting as fever of unknown origin: a case report. Hepatogastroenterology 2001; 48(37):112-
21. Indian Council for medical research (ICMR). Annual report of population based cancer registries of National Cancer Registry programme9 1996). New Delhi, ICMR publication, pg 18.
22. Pandey M, Pathak K, Gautam A et al. Carcinoma of the Gallbladder: A Retosepctive Review of 99 cases. Digestive Diseases and Sciences. 2001;46 (6): 1145-1151.
23. Esendagli G, Akarca FG, Balci S et al.A Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods:A Multicentre Study Turk Patoloji Derg 2018; 34:41-48.
24. Mondal B, Maulik D, Biswas BK, Sarkar GN, Ghosh D. Histopathological spectrum of gallstone disease from cholecystectomy specimen in rural areas of West Bengal, India- an approach of association between gallstone disease and gallbladder carcinoma. Int J Community Med Public Health 2016;3:3229-35.
25. Terada T. Histopathologic features and frequency of gall bladder lesions in consecutive 540 cholecystectomies. Int J Clin Exp Pathol 2013;6(1):91-96.
Published
2018-09-26
Section
Original Article