Gall bladder diseases: a study of histopathological spectrum of cholecystectomy specimens from rural tertiary hospital in Telangana state during COVID pandemic

Authors

  • Anuradha Vutukuru Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India
  • Nageshwar Rao Suragani Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India
  • Vallury Sailaja Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India
  • Vijay Sreedhar V. Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India
  • Mithila K. B. Department of Pathology, Bhaskar Medical College, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20232668

Keywords:

Pyloric metaplasia, Routine pathological examination, Xanthogranulomatous cholecystitis , Intracholecystic papillary neoplasm, Cholecystectomy

Abstract

Background: The debate of “is it worth spending the busy pathologist’s time on gall bladder specimens” has been there for decades. The selective approach may result in missing discrete pathologies such as premalignant lesions. We are presenting an interesting series of gall bladder histopathology diagnosed at our institute in the past two years.

Methods: This is a retrospective study done at Bhaskar Medical College between 2020-2022 (specifically chosen as this is the period of COVID pandemic). This study included 43 patients who underwent cholecystectomy. All confirmed cases of acute abdomen operated for other reasons and trauma were excluded. Sections were taken from neck, fundus, body and cross section of cystic duct of each cholecystectomy specimen. The whole gallbladder was submitted and screened for the invasion in ICPN case. These sections were processed through routine paraffin embedding, microtome cutting and H&E staining for evaluation of spectrum of various gallbladder lesions.

Results: In our study, 25 cases showed lymphoplasmacytic infiltration with fibrosis, 9 cases showed ulceration, congested blood vessels and neutrophilic infiltration. We encountered few rare cases like eosinophilic cholecystitis, xanthogranulomatous cholecystitis, and Intracholecystic papillary neoplasm (ICPN)”. Pyloric metaplasia was seen in 27.9% cases, which is also higher

Conclusions: Our study emphasizes the need for the routine examination of these specimens, to have a detailed understanding of the etiology to prevent/predict the other associated medical conditions. We also could find 2% of the cases having pre-malignant lesions and 28% having metaplasia, which if missed shall progress to malignant conditions.

References

Jha AK, Ali A, Kumar M, Kumar M, Bhadani PP, Murthy NBS, Chandrakant K. Outcome of routine histopathological examination of gallbladder specimen following elective laparoscopic cholecystectomy. J Carcinog. 2021;8(20):19.

Harendra K, Garima D, Hema K, Avani T, Minakshi B. Spectrum of gallbladder diseases- A comparative study in North Vs South Indian population. Indian J Pathol Oncol. 2018;5(2):273-6.

Siddiqui FG, Memon AA, Abro AH, Sasoli NA, Ahmad L. Routine histopathology of gallbladder after elective cholecystectomy for gallstones: waste of resources or a justified act? BMC Surg. 2013;8(13):26.

Vaishali DK, Kotasthane DS. 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?. Arch Cytol Histopathol Res. 2020;5(1):91-5

Kapoor VK. Incidental gallbladder cancer. Am J Gastroenterol. 2001;96(3):627-9.

Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: Development of an atlas ofcancer in India. Int J Cancer. 2005;116(5):740-54.

Nandakumar A, Gupta PC, Gangadharan P, Visweswara RN, Parkin DM. Geographic pathology revisited: development of an atlas of cancer in India. Int J Cancer. 2005;116(5):740-54.

Shanta V, Gajalakshmi V, Swaminathan V, Rama RR. Population Based Cancer Registry of India – the Challenges and Opportunities. Asian Pac J Cancer Prev. 2018;19(10):2885-9.

Jokhi C D, Kanetkar S R, Vohra N V, Study of histopathological findings in gallbladder diseases. Indian J Pathol Oncol. 2019;6(4):627-35

Gonzalez RS. WHO classification. Available at: https://www.pathologyoutlines.com/topic/gallbladderwhoclassification.html. Accessed on 27 April 2023.

Faik Y, Aysenur D, Bercis IU, Yalcin S, Zulfu B, Fahri Y. Cholesterolosis in routine histopathological examination after cholecystectomy: What should a surgeon behold in the reports? Int J Surg. 2014;12(11):1187-91.

Koike D, Kato H, Asano Y, Ito M, Arakawa S, Kawabe N, et al. Natural history of intracholecystic papillary neoplasm (ICPN): a rare case of ICPN whose natural history was closely followed by ultrasound. BMC Gastroenterol. 2022;22(1):377.

Khan S, Hassan MJ, Jairajpuri ZS, Jetley S, Husain M. Clinicopathological Study of Eosinophilic Cholecystitis: Five Year Single Institution Experience. J Clin Diagn Res. 2017;11(8):20-3.

Sharma R, Chander B, Kaul R, Rattan A, Sood A, Kumari K, Khajuria M. Frequency of gall bladder metaplasia and its distribution in different regions of gall bladder in routine cholecystectomy specimens. Int J Res Med Sci. 2018;6:149-53.

Downloads

Published

2023-08-29

How to Cite

Vutukuru, A., Suragani, N. R., Sailaja, V., V., V. S., & K. B., M. (2023). Gall bladder diseases: a study of histopathological spectrum of cholecystectomy specimens from rural tertiary hospital in Telangana state during COVID pandemic. International Journal Of Community Medicine And Public Health, 10(9), 3132–3136. https://doi.org/10.18203/2394-6040.ijcmph20232668

Issue

Section

Original Research Articles