Histopathologic features and frequency of gall bladder lesions in consecutive 540 cholecystectomies.

The frequency of gall bladder lesions in cholecystectomies is not clear. The purpose of the present study is to report the morphologies and frequency of gall bladder diseases and lesions of 540 cholecystectomies in the last 10 years in our pathology laboratory. The age of patients ranged from 18 years to 93 years with a mean of 64.75 ±14.43 years. Male to female ratio was 213:327. Of these, 518 cases (96%) had gall stones. Eight (1.5%) were acute cholecystitis, 508 (94.1%) were chronic cholecystitis, 12 (2.2%) were adenocarcinomas, 1 (0.2%) was cystadenocarcinoma, and 11 (2.0%) were normal gall bladders. The frequency of histological lesions were as follows: acute gangrenous inflammation (8 cases, 1.5%), Rokitansky-Aschoff sinuses (RAS) (351 cases, 65%), microliths or inspissated bile in RAS (108 cases, 20%), adenomyomatous changes (16 cases, 3.0 %), focal abscess formations (12 cases, 2.2%), focal xanthogranulomatous changes (15 cases, 2.8%), mucosal ulcers (61 cases, 11.3%), cholesterosis (62 cases, 11%), cholesterol polyp (32 cases, 6%), pyloric gland metaplasia (292 cases, 54%), adenoma (7 cases, 1.3%), xanthogranulomatous cholecystitis (5 cases, 1%), invasive adenocarcinoma (12 cases, 2.2%), and cystadenocarcinoma (1 cases, 0.2%). In adenomyomatous changes, the epithelial proliferation was florid in a few cases, and no perineural invasions were seen. In pyloric gland metaplasia, no perineural invasions were recognized. All the 7 cases of adenoma were of intestinal type. In the 12 adenocarcinoma cases, one case arose in RAS without mucosal involvement, and 9 were tubular adenocarcinomas and 3 were papillary adenocarcinomas and 1 was mucinous adenocarcinoma. In the present series, there were no cases of heterotipc tissue, intestinal metaplasia, intraepithelial neoplasm, and other malignancies. These data may provide basic knowledge of the gall bladder pathologies.