Histomorphological Spectra of Gallbladder Specimens after Cholecystectomy in Benign Disease

Background: The gallbladder is a surgically important organ, most often subjected to cholecystectomy for treating cholelithiasis. The presence of gallstones may precipitate the development of cholecystitis which may even lead to gallbladder malignancy, if not treated in time. Aim: The aims were to study the diverse morphological, histopathological and histochemical features of gallbladder specimens obtained at cholecystectomy done for various benign diseases of the GB. Material and methods: Included are 132 specimens of the gallbladder obtained at cholecystectomy done for benign diseases at Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India. The specimens thus obtained were studied for the morphological and histopathological changes. Each specimen was subjected to Sudan Black B, Methyl Green-Pyronin Y and Periodic acid-Schiff staining to confirm presence of lipid, plasma cells and glycogen, respectively in GB tissue samples. Results and Conclusion: Cholelithiasis was predominantly a female disease. The size of the GB varied from < 7 cm (shrunken) to > 10 cm (distended). Cholelithiasis was present in 97.73% of the cases studied. Of these, 89.14 % had mixed stones and 10.85%, cholesterol stones. Of the cases studied, 8.33% had acute cholecystitis alone. It was associated with mucocoele or empyema of the GB in 3.79% and 5.30% cases, respectively. Histopathological changes consistent with chronic cholecystitis and cholesterolosis, respectively were seen in 76.52% and 6.06% cases. In the former patients, the presence of theplasma cells in the GB tissues was confirmed using MGPY staining. The presence of lipids in the GB tissue samples of the latter was confirmed using Sudan Black B staining. Cases of chronic cholecystitis with ectopic pancreatic tissue, colonic metaplasia and xanthogranuloma were also seen. Mixed atrophic-hyperplastic mucosa, being the commonest mucosal change was seen in 63.64% cases. Other mucosal changes included atrophic mucosa (in 21.21 % cases) and hyperplasia (in 15.15% cases). The GB tissue samples in 7.5% cases showed PAS-positive mucinous metaplasia. The tissue samples obtained at cholecystectomy performed for various benign gallbladder diseases showed varieties of histomorphological changes, including metaplasia and precursor changes suggesting the high risk for gallbladder malignancy. This underscores the need for routine histopathological examination of appropriate tissue samples of the gallbladder obtained at cholecystectomy