Turkish Journal of Pathology

Türk Patoloji Dergisi

Turkish Journal of Pathology

Turkish Journal of Pathology

2018, Vol 34, Num, 1     (Pages: 041-048)

A Retrospective Evaluation of the Epithelial Changes/Lesions and Neoplasms of the Gallbladder in Turkey and a Review of the Existing Sampling Methods: A Multicentre Study

Güldal Esendağlı 1, F. Göknur Akarca 1, Serdar Balcı 2, Asuman Argon 3, Selma Şengiz Erhan 4, Nesrin Turhan 5, Neslihan İnce Zengin 5, Sevinç Hallaç Keser 6, Betül Çelik 7, Tangül Bulut 7, Samir Abdullazade 8, Esra Erden 9, Berna Savaş 9, Temmuz Bostan 9, Özgül Sağol 10, Anıl Aysal Ağalar 10, Nuray Kepil 11, Yıldırım Karslıoğlu 12, Armağan Günal 12, Fatma Markoç 13, Burcu Saka 14, Gonca Özgün 15, Şükrü Oğuz Özdamar 16, Burak Bahadır 16, Esin Kaymaz 16, Emre Işık 16, Semin Ayhan 17, Deniz Tunçel 18, Banu Özgüven Yılmaz 18, Sevinç Çelik 19, Tuba Karabacak 20, İpek Erbarut Seven 21, Çiğdem Ataizi Çelikel 21, Zuhal Gücin 22, Özgür Ekinci 1, Gülen Akyol 1

1 Department of Medical Pathology, Gazi University School of Medicine, Ankara, Turkey
2 Department of Medical Pathology, Ankara University Yıldırım Beyazıt School of Medicine, Ankara, Turkey
3 Department of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir, Turkey
4 Department of Pathology, Okmeydani Training and Research Hospital, Istanbul, Turkey
5 Department of Pathology, Turkiye Yuksek İhtisas Training and Research Hospital, Ankara, Turkey
6 Department of Pathology, Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
7 Department of Pathology, Department of Medical Pathology, University of Health Science, Antalya Training and Research Hospital, Antalya, Turkey
8 Department of Pathology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
9 Department of Medical Pathology, Ankara University School of Medicine, Ankara, Turkey
10 Department of Medical Pathology, Dokuz Eylül University School of Medicine, Izmir, Turkey
11 Department of Medical Pathology, İstanbul University, Cerrahpaşa School of Medicine, Istanbul, Turkey
12 Department of Pathology, Gülhane Training and Research Hospital, Ankara, Turkey
13 Department of Pathology, Dr. Abdurrahman Yurtaslan Ankara Onkoloji Training and Research Hospital, Ankara, Turkey
14 Department of Pathology, Istanbul University Medipol School of Medicine, Istanbul, Turkey
15 Department of Medical Pathology, Başkent University School of Medicine, Ankara, Turkey
16 Department of Medical Pathology, Bülent Ecevit University School of Medicine, Zonguldak, Turkey
17 Department of Medical Pathology, Celal Bayar University School of Medicine, Manisa, Turkey
18 Department of Medical Pathology, Department of Pathology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
19 Department of Medical Pathology, Bozok University School of Medicine, Yozgat, Turkey
20 Department of Medical Pathology, Mersin University School of Medicine, Mersin, Turkey
21 Department of Pathology, Marmara University School of Medicine, Pendik Training and Research Hospital, İstanbul, Turkey
22 Department of Medical Pathology, Bezmialem Foundation University School of Medicine, İstanbul, Turkey

DOI: 10.5146/tjpath.2017.01404
Viewed: 5797
 - 
Downloaded : 3198

Objective: As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols.

Material and Method: With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages.

Results: Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories.

Conclusion: The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute's oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.

Keywords : Gallbladder, Cholecystectomy, Dysplasia, Neoplasia, Sampling