A histopathological and histochemical study of cholecystitis

Abstract

histochemistry, composition of calculi and metaplasia, fibrosis and mucin histochemistry, fibrosis and stone composition indicated a decrease in intraepithelial total acid mucin content in chronic calculous cholecystitis. cases with severe inflammation showed the maximum decrease in sulfomucin, concomitant increase in sialomucin scores and a high incidence of gastric metaplasia. Intestinal metaplasia on other hand did not correlate with the degree of inflammation or sialomucin content. conclusion: this study concludes that normally gallbladder epithelium contains sulfated acid mucins with traces of neutral and sialomucins. the sulfomucin content decreases in chronic calculous cholecystitis and with severe inflammation, total acid mucin content decreases, neutral mucin increases, and there is a higher incidence of gastric metaplasia and pigment stones and correlating with pigment stones. this tends to have an association with severe inflammation, higher degree of fibrosis, gastric metaplasia and presence of sialomucin. Keywords: chronic calculous cholecystitis, Gallbladder stones, Metaplasia, Mucin histochemistryHow to cite this article Anupama P, Menon Nirmala V, Janaky R, Mohammed IL, Alingal MB, Sideeque NA. A histopathological and histochemical study of cholecystitis. Int J Hepatobiliary Pancreat Dis 2014;4:70-80.

Quantitative Analysis of Mucin Expression Using Combined Alcian Blue-Periodic Acid Schiff (AB-PAS) Stain and Combined High Iron Diamine-Alcian Blue (HID-AB) Stain and the Correlation With Histomorphological Score in Chronic Calculous Cholecystitis

“…In the present study, the most common age group affected was 31 to 40 years which is in concordance with other studies done by Anupama et al, Thamilselvi et al, and Mathur et al [ 6 - 8 ]. This age group predilection might be attributed to dyslipoproteinemia; as age progresses, there is an increase in the release of cholesterol into the bile associated with a decrease in bile synthesis.…”

“…A significant negative correlation was observed between an increase in grades of severity with a decrease in acidic mucin and sulfomucin of both superficial and deep epithelium, except sulfomucin in fibrosis. These findings were identical to the study conducted by Srivastava et al and Anupamaet al [ 1 , 6 ]. Pani et al found that a major amount of mucin in cholelithiasis and cholecystitis was sulfomucin and sialomucin, respectively.…”

“…Based on the degree of fibrosis observed and compared using both H&E stain and Masson's trichrome stain, a predominantly mild and moderate degree of fibrosis was observed. The results were comparable with studies done by Barcia and Anupama et al, where they found that the frequency of mild and severe degrees of fibrosis was almost closer to each other [ 5 , 6 ]. Fibrosis could be due to incomplete healing of an acute injury, which leads to collagen deposition initially in the disordered pattern followed by rare orderly/lamellated arrangement in long-standing cases of chronic cholecystitis.…”

“…Mucin expression of superficial and deep lining epithelium of chronic calculous cholecystitis was assessed using a detailed scoring system [ 6 ]. Sections from all specimens stained with both stains were quantitatively scored.…”

“…Most of the cases fell under the moderate and severe degree of inflammation, 24 (38%) and 25 (39%) cases, respectively, which were similar to the study done by Anupama et al, where inflammation in cholecystitis was due to obstruction by calculi, which in turn leads to mucosal injury. Prolonged inflammation reveals a predominant B lymphocyte population, and when neutrophilic activity accompanies the mild to moderate chronic inflammation, it also exhibits T lymphocytes which are limited to affected areas [ 6 , 9 ].…”