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Int J Clin Exp Pathol 2013;6(1):91-96

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

Tadashi Terada

Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan

Received September 19, 2012; Accepted October 27, 2012; Epub November 20, 2012; Published January 1, 2013

Abstract: 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. (IJCP1209013).

Keywords: Gall bladder, incidence, histopathology

Address all correspondence to:
Dr. Tadashi Terada
Department of Pathology
Shizuoka City Shimizu Hospital
Miyakami 1231 Shimizu-Ku
Shizuoka 424-8636, Japan.
Tel: 81-54-336-1111; Fax: 81-54-336-1315
E-mail: piyo0111jp@yahoo.co.jp