Gaharwar A, Mishra SR, Kumar V (2016) Histomorphological Spectra of Gallbladder Specimens after Cholecystectomy in Benign Disease. Int J Anat Appl Physiol. 2(5), 49-56
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International Journal of Anatomy & Applied Physiology (IJAAP)
ISSN 2572-7451
Histomorphological Spectra of Gallbladder Specimens after Cholecystectomy in Benign Disease
Research Article
Gaharwar A
1
, Mishra SR
1*
, Kumar V
2
1
Department of Anatomy, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India.
2
Department of Anatomy, Rural Institute of Medical Science and Research, Saifai, Uttar Pradesh, India.
Introduction
Disorders of the gallbladder are a common surgical condition
throughout the world. Cholecystectomy is the mainstay of
treatment for cholelithiasis and the laparoscopic cholecystectomy
is the gold standard management of symptomatic cholelithiasis
[1, 2]. Chronic cholecystitis is associated with cholelithiasis in
> 90% of cases [3]. Although symptomatic cholelithiasis per
se is a benign condition, gallstones are a known risk factor for
gallbladder malignancy (GBM) which has a very poor prognosis
[2-4]. Cholelithiasis produces diverse histopathological changes
in the gallbladder. These include acute or chronic inlammation,
xanthogranulomatous cholecystitis, glandular hyperplasia,
cholesterosis, and metaplasia (gastric or intestinal), dysplasia and
carcinoma [3]. The incidence of the gallbladder cancer varies
in different races and geographic regions [3, 5]. The incidence
*Corresponding Author:
Suniti R Mishra
Professor, Department of Anatomy, G.S.V.M. Medical College, Kanpur, Uttar Pradesh, India.
Tel: 09959994994
E-mail: dr.sunti@yahoo.co.in
Received: July 05, 2016
Accepted: August 24, 2016
Published: August 31, 2016
Citation: Gaharwar A, Mishra SR, Kumar V (2016) Histomorphological Spectra of Gallbladder Specimens after Cholecystectomy in Benign Disease. Int J Anat Appl Physiol. 2(5), 49-56.
doi: http://dx.doi.org/10.19070/2572-7451-160008
Copyright: Mishra SR
©
2016. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution
and reproduction in any medium, provided the original author and source are credited.
Abstract
Background: The gallbladder is a surgically important organ, most often subjected to cholecystectomy for treating chole-
lithiasis. The presence of gallstones may precipitate the development of cholecystitis which may even lead to gallbladder
malignancy, if not treated in time.
Aim: The aims were to study the diverse morphological, histopathological and histochemical features of gallbladder speci-
mens obtained at cholecystectomy done for various benign diseases of the GB.
Material and methods: Included are 132 specimens of the gallbladder obtained at cholecystectomy done for benign dis-
eases at Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India. The specimens thus obtained
were studied for the morphological and histopathological changes. Each specimen was subjected to Sudan Black B, Methyl
Green-Pyronin Y and Periodic acid-Schiff staining to conirm presence of lipid, plasma cells and glycogen, respectively in
GB tissue samples.
Results and Conclusion: Cholelithiasis was predominantly a female disease. The size of the GB varied from < 7 cm
(shrunken) to > 10 cm (distended). Cholelithiasis was present in 97.73% of the cases studied. Of these, 89.14 % had mixed
stones and 10.85%, cholesterol stones. Of the cases studied, 8.33% had acute cholecystitis alone. It was associated with mu-
cocoele or empyema of the GB in 3.79% and 5.30% cases, respectively. Histopathological changes consistent with chronic
cholecystitis and cholesterolosis, respectively were seen in 76.52% and 6.06% cases. In the former patients, the presence
of theplasma cells in the GB tissues was conirmed using MGPY staining. The presence of lipids in the GB tissue samples
of the latter was conirmed using Sudan Black B staining. Cases of chronic cholecystitis with ectopic pancreatic tissue, co-
lonic metaplasia and xanthogranuloma were also seen. Mixed atrophic-hyperplastic mucosa, being the commonest mucosal
change was seen in 63.64% cases. Other mucosal changes included atrophic mucosa (in 21.21 % cases) and hyperplasia (in
15.15% cases). The GB tissue samples in 7.5% cases showed PAS-positive mucinous metaplasia.
The tissue samples obtained at cholecystectomy performed for various benign gallbladder diseases showed varieties of
histomorphological changes, including metaplasia and precursor changes suggesting the high risk for gallbladder malig-
nancy. This underscores the need for routine histopathological examination of appropriate tissue samples of the gallbladder
obtained at cholecystectomy.
Keywords: Cholecystitis; Cholelithiasis; Empyema; Gallstone; Mucosa; Mucocoele.