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

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.