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Precancerous Gallbladder Lesions in Cholelithiasis: A Histopathological Study
Umesh Choudhary1, Sanjay Kumar Saroj2, Devendra Singh Shekhawat1
1Department of Anatomy, Institute of Medical Sciences, Banaras Hindu University, Varanasi, IND.
Cureus
|January 15, 2026
Summary
Gallbladder cancer precursor lesions like hyperplasia and dysplasia are common in gallstones. Elevated alkaline phosphatase indicates tissue injury, underscoring the need for histopathology in early detection.
Area of Science:
- Gastroenterology
- Oncology
- Pathology
Background:
- Gallbladder cancer (GBC) has high prevalence and late diagnosis in Northern/Eastern India.
- Metaplasia-dysplasia-carcinoma sequence is key in gallbladder carcinogenesis.
- Identifying precursor lesions in cholelithiasis is crucial for early GBC detection.
Purpose of the Study:
- Examine precancerous mucosal changes in patients with cholelithiasis.
- Evaluate histopathological patterns of these changes.
- Assess their clinical relevance for early gallbladder cancer detection.
Main Methods:
- Cross-sectional study of 100 patients with ultrasonography-confirmed cholelithiasis undergoing cholecystectomy.
- Exclusion of patients with hepatic or metabolic comorbidities.
- Recording of clinical, hematological, and biochemical parameters; histopathological examination of resected gallbladder specimens.
Main Results:
- Epithelial hyperplasia (58%), low-grade dysplasia (22%), and intestinal metaplasia (10%) were common histopathological findings.
- Normal mucosa observed in only 10% of cases (p < 0.001).
- Serum alkaline phosphatase levels significantly increased with cholelithiasis severity (p < 0.0001).
Conclusions:
- Chronic cholelithiasis is linked to significant mucosal changes, supporting the metaplasia-dysplasia-carcinoma sequence.
- Progressive rise in alkaline phosphatase indicates ongoing tissue injury.
- Routine histopathological examination is vital for early detection of gallbladder precancerous lesions.
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