Morphological spectrum of gall bladder lesions and their correlation with cholelithiasis

Background: Gall stones are known to produce diversified histological changes in the gallbladder such as inflammation, metaplasia, hyperplasia, dysplasia and even precursor lesions of malignancy. The aim of our study was to correlate the various histological changes in the gallbladder with the different types of gallstones (cholesterol, pigmented and mixed). Methods: This prospective study was conducted in the department of Pathology, Indira Gandhi Medical College, Shimla, Himachal Pradesh from July 2014 to June 2015. The age, sex distribution and the incidence of different types of gallstones was studied. The histological changes in the gallbladders were examined and its correlation with the type of gallstones was evaluated. Results: In all 1371 specimens of gall bladder were received during this period. The mean age of the patients was 44 years (age range 13-86 years) with Male: Female ratio of 1: 8.3. Out of the total 1371 cholecystectomy specimens, 1259 (91.8 %) had calculi and 112 (8.2%) were acalculus. Of the 1259 cases of calculus disease, mixed stones were observed in 840 (66.7%) patients, cholesterol stones in 289 (22.9%) and pigmented stones in 130 (10.4%) patients. Overall 1291 (94%) cases had chronic cholecystitis followed by acute cholecystitis and chronic active cholecystitis in 2% each, dysplasia in 1.5% and carcinoma cases 0.5%. Conclusions: Routine cholecystectomy performed for a common condition like gallstone disease can result in detection of diverse and wide spectrum of histopathological lesions ranging from chronic cholecystitis to carcinoma.