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[Neoplasms and dysplasias of the gallbladder and their relationship with lithiasis. A case-control
G Martínez-Guzmán1, J de la Rosa-Bayón
1Servicio de Anatomía Patológica del Hospital General de Zona y Medicina Familiar No. 1, Instituto Mexicano del Seguro Social, Pachuca, Hgo, México.
Background:
A strong association has been reported between gallbladder carcinoma, premalignant epithelial or metaplasic inflammatory lesions and cholelithiasis, varying the incidence among different ethnic groups.
Purpose:
To determine the frequency of association between such lesions and gallbladder lithiasis.
Material And Methods:
We examined histopathologic changes in 1,367 cholecystectomy specimens with (1,096) or without (271) lithiasis and established its frequency of association, correlating with main clinical data.
Results:
Overall, 80% had lithiasis. In this group, pseudopyloric metaplasia (50%), intestinal metaplasia (16%), low grade dysplasia (40%), high grade dysplasia (16%), carcinoma in situ (1.5%) and invasive carcinoma (2.6%) were observed compared to 25%, 2%, 17%, 2%, 0%, and 0% in the control group. The findings of 80% with lithiasis, 65% with carcinoma in situ and 90% of invasive carcinoma, all were in women. Median age of patients with low and high grade dysplasia, carcinoma in situ and invasive carcinoma was 42, 48, 53 and 61 years, respectively.
Conclusions:
Acute and xanthogranulomatous cholecystitis, adenomyomatosis, pseudopyloric and intestinal metaplasia, hyperplastic polyps, low and high grade dysplasia, tubular adenomas, carcinoma in situ and invasive carcinoma were more frequent when cholelithiasis was present (p < .05) than in cases without lithiasis.