Histo morphological changes in gall bladder mucosa associated with gall stones

Abhay Singh; Shachi Shachi; G Mahantesh

doi:10.53730/ijhs.v7nS1.14203

Authors

Abhay Singh Assistant Professor, Department of General Surgery, Venkatashwar Institute of Medical Sciences, Gajraula, Uttar Pradesh
Shachi Shachi
Drshachi.Ahlawat@gmail.com
Associate Professor, Department of Pathology, Venkatashwar Institute of Medical Sciences, Gajraula, Uttar Pradesh
Mahantesh G Assistant Professor, Department of Pathology, Venkatashwar Institute of Medical Sciences, Gajraula, Uttar Pradesh

Keywords:

Cholelithiasis, gallbladder mucosa, histopathology

Abstract

Background and Aims: Cholelithiasis is known to produce diverse histopathological changes in the gallbladder mucosa. In the present study, we aimed to find the correlation between various gallstone characteristics (i.e., number, size, and morphological type) with the type of mucosal response in gallbladder mucosa (i.e., inflammation, hyperplasia, metaplasia, and carcinoma). Methods: The present study was conducted prospectively on 250 patients undergoing cholecystectomy for symptomatic cholecystitis. Gallstones were assessed for various parameters, i.e., number, size, and morphological type. Gallbladder mucosa was subjected to histopathological examination. Sections were taken from body, fundus, and neck of gallbladder. Results: Of 250 cases, maximum type was of mixed stones (54%) and was multiple in number (46%). However, gallstone type and number are non-significant variables to produce precancerous lesions (i.e., hyperplasia and metaplasia). Statistically significant results were obtained while comparing the mucosal response with gallstone size (P = 0.012). Conclusion: As the gallstone size increases, the response in gallbladder mucosa changes from cholecystitis, hyperplasia, and metaplasia to carcinoma. Gallstone type and number are nonsignificant variables to produce precancerous lesions.

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References

Mathur SK, Duhan A, Singh S, Aggarwal M, Aggarwal G, Sen R, et al. Correlation of gallstone characteristics with mucosal changes in gall bladder. Trop Gastroenterol. 2012;33:39–44. [PubMed] [Google Scholar]

Njeze GE. Gallstones. Niger J Surg. 2013;19:49–55. [PMC free article] [PubMed] [Google Scholar]

Baidya R, Sigdel B, Baidya NL. Histopathological changes in gallbladder mucosa associated with cholelithiasis. J Pathol Nepal. 2012;2:224–5. [Google Scholar]

Narang S, Goyal P, Bal MS, Bandlish U, Goyal S. Gall stones size, number, biochemical analysis and lipidogram- an association with gall bladder cancer: A study of 200 cases. Int J Cancer Ther Oncol. 2014;2:020310. [Google Scholar]

Mohan H, Punia RP, Dhawan SB, Sekhon MS. Morphological spectrum of gallstone disease in 1100 cholecystectomies in North India. Indian J Surg. 2005;67:140–2. [Google Scholar]

Khanna R, Chansuria R, Kumar M, Shukla HS. Histological changes in gallbladder due to stone disease. Indian J Surg. 2006;68:201–4. [Google Scholar]

Tyagi SP, Tyagi N, Maheshwari V, Ashraf SM, Sahoo P. Morphological changes in diseased gall bladder: A study of 415 cholecystectomies at Aligarh. J Indian Med Assoc. 1992;90:178–81. [PubMed] [Google Scholar]

Singh UR, Agarwal S, Misra K. Histopathological study of xanthogranulomatous cholecystitis. Indian J Med Res. 1989;90:285–8. [PubMed] [Google Scholar]

Baig SJ, Biswas S, Das S, Basu K, Chattopadhyay G. Histopathological changes in gallbladder mucosa in cholelithiasis: Correlation with chemical composition of gallstones. Trop Gastroenterol. 2002;23:25–7. [PubMed] [Google Scholar]

Johnston DE, Kaplan MM. Pathogenesis and treatment of gallstones. N Engl J Med. 1993;328:412–21. [PubMed] [Google Scholar]

Stancu M, Căruntu ID, Giuşcă S, Dobrescu G. Hyperplasia, metaplasia, dysplasia and neoplasia lesions in chronic cholecystitis – A morphologic study. Rom J Morphol Embryol. 2007;48:335–42. [PubMed] [Google Scholar]

Elfving G, Teir H, Degert H, Mäkelä V. Mucosal hyperplasia in the gallbladder demonstrated by plastic models. Acta Pathol Microbiol Scand. 1969;77:384–8. [PubMed] [Google Scholar]

Jung SE, Lee JM, Lee K, Rha SE, Choi BG, Kim EK, et al. Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern. Eur Radiol. 2005;15:694–701. [PubMed] [Google Scholar]

Bazoua G, Hamza N, Lazim T. Do we need histology for a normal-looking gallbladder? J Hepatobiliary Pancreat Surg. 2007;14:564–8. [PubMed] [Google Scholar]

Vitetta L, Sali A, Little P, Mrazek L. Gallstones and gall bladder carcinoma. Aust N Z J Surg. 2000;70:667–73. [PubMed] [Google Scholar]

Lowenfels AB, Lindström CG, Conway MJ, Hastings PR. Gallstones and risk of gallbladder cancer. J Natl Cancer Inst. 1985;75:77–80. [PubMed] [Google Scholar]

Hsing AW, Gao YT, Han TQ, Rashid A, Sakoda LC, Wang BS, et al. Gallstones and the risk of biliary tract cancer: A population-based study in China. Br J Cancer. 2007;97:1577–82. [PMC free article] [PubMed] [Google Scholar]

Roa I, Ibacache G, Roa J, Araya J, de Aretxabala X, Muñoz S, et al. Gallstones and gallbladder cancer-volume and weight of gallstones are associated with gallbladder cancer: A case-control study. J Surg Oncol. 2006;93:624–8. [PubMed] [Google Scholar]

Moerman CJ, Lagerwaard FJ, Bueno de Mesquita HB, van Dalen A, van Leeuwen MS, Schrover PA, et al. Gallstone size and the risk of gallbladder cancer. Scand J Gastroenterol. 1993;28:482–6. [PubMed] [Google Scholar]