[Epithelial lesions associated with gallbladder carcinoma. A methodical study of 32 cases]

Using mapping techniques, 32 consecutive gallbladder carcinomas diagnosed in our department were studied. The defined lesions were dysplasia, carcinoma in situ and superficial spreading carcinoma. A total of 2257 lesions were recorded from 1072 inclusions. All the defined lesions were present in about 10% of all sections. However, if each case is considered separately, dysplasia was present in 81.3% of cases, carcinoma in situ in 65.6% of cases and superficial spreading carcinoma in 68.8% of cases. An isolated focus of atypical epithelium without anatomic relation with the main tumor was demonstrated in only 3 cases and a close relation between invasive carcinoma and dysplastic lesions was observed in the remainder. Infiltration of Rokistansky-Aschoff sinuses was observed in 40% of cases. We were not able to demonstrate, on histological basis, differences between superficial spreading carcinoma and carcinoma in situ. We conclude that atypical lesions of the gallbladder are not frequently seen and that their presence must prompt the search of a carcinomatous lesion by means of serial sections of all the histological sample.