Study of histopathological spectrum of cholecystectomy specimens received in a government hospital

Abstract

Introduction: Gall bladder analysis for various lesions was conducted. Chronic cholecystitis is was most commonly encountered lesion. Cholelithiasis and incidentally diagnosed carcinoma constitutes more than 95% and 0.5-1.09% of gall bladder lesions respectively. So, every specimen should undergo histopathological examination. Aims and objectives: i) To study various histopathological lesions of gall bladder ii) To evaluate the incidence of incidental gall bladder carcinoma. Materials and Methods: A cross-sectional study of 430 cholecystectomy specimens was conducted at Pathology Department, GMERS Medical College and General Hospital, Sola, Ahmedabad from February 2017 to March 2019 (2 years). Specimens received in 10% Neutral Formalin were processed and Haematoxylin and Eosin sections were studied. Results: We studied 430 cholecystectomy specimens. Females showed predominance (294 cases; 68.5%) with male-female ratio of 1:2.2. Most commonly affected age group was 21-40 years (154 cases, 35.8%), followed by 41-60 years (135 cases, 31.5%). The most common diagnosis was chronic calculous cholecystitis (279 cases, 65%). Others were chronic acalculous cholecystitis (114 cases, 26.4%), acute on chronic cholecystitis (13 cases, 3.1%), cholesterolosis (5 cases,1.2%), acute cholecystitis (4 cases,0.9%), xanthogranulomatous cholecystitis (4 cases,0.9%) and acute suppurative cholecystitis (2 cases,0.4%) with one case of adenomyomatosis (0.2%). Four cases of adenomas (ICPN- Intracholecystic Papillary-Tubular Neoplasms) and four cases of incidentally detected gall bladder carcinoma were obtained. Conclusion: The microscopic examination of cholecystectomy specimens is required to study various lesions and to detect carcinomas which are difficult to diagnose grossly. Thus, histopathological examination is the gold standard diagnostic tool. Keywords: Cholecystectomy, cholecystitis, cholelithiasis, Intracholecystic Papillary-tubular Neoplasms (ICPN), Signet ring adenocarcino