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Evaluating Intestinal Metaplasia in Pediatric Gallbladder Specimens: Clinicopathologic Significance and Sampling
Adeyinka Akinsanya1, Iván A González1
1Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Insights
Intestinal metaplasia (IM) in pediatric gallbladders, often linked to gallstones and inflammation, does not require additional sampling. This finding is crucial for pediatric pathology practices.
Area of Science:
- Pediatric Pathology
- Gastrointestinal Pathology
Background:
- Intestinal metaplasia (IM) in adult gallbladders is a precursor to dysplasia and cancer.
- The clinical significance and appropriate pathological sampling of IM in pediatric gallbladders remain unclear.
Purpose of the Study:
- To investigate the significance of IM in pediatric gallbladder specimens.
- To establish appropriate histological sampling guidelines for IM in children.
Main Methods:
- Retrospective review of 25 pediatric cholecystectomy cases with identified IM.
- Analysis of clinical and histological findings, including additional tissue sectioning.
Main Results:
- IM was found in 25 pediatric cases, predominantly in females (92%) undergoing surgery for cholelithiasis (84%).
- No instances of dysplasia or adenocarcinoma were identified in any of the cases.
- Additional sampling revealed IM in 52% of cases, with an average of 3.9 extra slides examined.
Conclusions:
- IM in pediatric gallbladders frequently co-occurs with gallstones and chronic inflammation.
- Current evidence suggests no additional pathological sampling is necessary for incidentally discovered IM in pediatric gallbladders.
Background:
Gallbladders are a commonly encounter specimen in pediatric pathology practice. In the adult population, intestinal metaplasia (IM) in the gallbladder is associated with the development of dysplasia and adenocarcinoma; however, in children its significance is unknown, and the appropriate sampling has not been described which is the goal of this study.
Methods:
Twenty-five routine pediatric cholecystectomy cases with IM were identified, and their clinical and histologic findings were reviewed.
Results:
Of these 25 cases, 23 were female (92%). The most common indication for surgery was cholelithiasis (84%). Stones were present in 21 cases (84%). Twenty-three cases (92%) had additional sections submitted with an average of 3.9 slides (range = 3-6), and 52% had IM in additional blocks. However, no dysplasia or carcinoma was identified in any case.
Conclusion:
IM in the gallbladder is frequently seen in the setting of gallstones and chronic inflammation. Based on our experience, no additional sampling is required when incidentally identified.
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