Abstract :
Background: Specimens of cholecystectomy performed for clinically benign diseases, mostly cholecystitis, are usually submitted for routine histopathological examination. Sometimes, the specimen contains neoplastic disease which include intracholecystic papillary neoplasm with dysplasia, low-grade or high-grade dysplasia, adenocarcinoma and other entities. It is important to identify these lesions for further patient management and risk assessment.
Aim of the Study: This study was undertaken in a tertiary care hospital in eastern India to determine the spectrum of incidental neoplastic lesion in specimen of routine cholecystectomy performed for clinically benign diseases and the relative incidence of these entities as this influences further patient management and validates the need for careful gross and microscopic examination of these specimens.
Materials and Methods: We identified one thousand seven hundred and ninety-five specimen of cholecystectomy done during the period of January 2023 to July 2024 and these were analysed for age, sex, imaging findings, preoperative clinical findings, intraoperative findings and histopathological findings. Cholecystectomy performed for known malignant diseases were excluded.
Results: Out of the total 1795 cases, 1474 cases were diagnosed as chronic cholecystitis, 264 cases were diagnosed as acute on chronic cholecystitis, 36 cases were diagnosed as xanthogranulomatous cholecystitis, 6 cases were diagnosed as adenocarcinoma, 7 cases were diagnosed as low-grade dysplasia, 5 cases diagnosed as intra cholecystic papillary neoplasm with dysplasia, 2 cases as high grade dysplasia/ intraepithelial carcinoma and one extra-intestinal GIST.
Conclusion: The relative incidence of incidental gallbladder adenocarcinoma was found to be 0.33, low-grade dysplasia was 0.39%, high grade dysplasia/ carcinoma in situ was 0.12%, extra intestinal GIST were found to be 0.06% and intra cholecystic papillary neoplasia with dysplasia was found to be 0.28%. All of these cases were associated with gallstone disease and cholecystitis except one case of intra cholecystic papillary neoplasm.
Keyword :
Gall bladder, Intracholecystic Papillary neoplasm, Adenocarcinoma.