Histopathological spectrum of gall Bladder diseases in cholecystectomy specimens at a Rural tertiary hospital of Purvanchal in North India-Does it differ from South India?

Abstract

Gall Bladder (GB) diseases are one of the most common digestive system diseases, the prevalence of which is variable within India and ranges from 2-29%. Cholelithiasis (gallstones) is the commonest lesion and accounts for more than 95% of GB diseases. Gall bladder carcinoma showed regional differences in India with prevalence ranging from 0.52% in southern India and as high as 9.6% in northern India. 1)To identify the morphological spectrum of diseases affecting the gall bladder. 2)To identify the most common histopathological lesion and its correlation with clinical and demographic data of the patient. 3)T o identify the frequency of Gall Bladder Carcinoma (GBC) and its correlation with clinical and demographic data of the patient and pre-existing lesions if any. This study was non-participatory descriptive study carried out retrospectively for a period of one year in the Dept. of Pathology, HIMS,from August 2018 to July 2019. All the specimens received in the study period were included in the study. The gross and microscopic findings on H & E slide were included in the study. The descriptive statistics w as applied to analysed data. Total 86 cholecystectomy specimens were received in the Department of Pathology during one year study period. Non-neoplastic lesions (97.67%) of gall bladder outnumbered the neoplastic lesions (2.33%). Most common histopathological lesion was chronic cholecystitis (95.34%). Varied histopathological spectrum was seen comprising of chronic calculous cholecystitis (73.26%), chronic acalculous cholecystitis (13.95), chronic cholecystitis with cholesterosis (13.95%), Xanthogranulomatous cholecystitis (2.33)%), Acute calculous cholecystitis (1.16%), acute gangrenous GB (1.16%), GBC (2.33%). In non-neoplastic lesions, female predilection (70.24%) was seen over male (29.76%) accounting for F:M ratio of 2.4:1, two cases of GBC exclusively seen in females associated with gall stones. Non-neoplastic lesions were common between the age group of 26-50 years accounting for 67.45% where as neoplastic lesions were common in the age group of >60years. Chronic cholecystitis with pigmented gall stone was the commonest GB disease in the present study. The study also revealed that females have increased preponderance for the development of all the gall bladder diseases including malignancy. Non-neoplastic lesions were more common till 5 decade in the present study whereas females in the 5th and 6th decade of life were prone for malignancy of gall bladder which was associated with gall stones.