The chronic cholecystitis and cholelithiasis are the most common pathologies seen in gallbladder disease, accompanying hyperplastic and dysplastic lesions. Generally three samples are taken from the cholecystectomized materials in routine pathology laboratories. We investigate whether there would be an increase in the frequency of hyperplasia, metaplasia and dysplasia diagnosis by increasing, the sample size. We also looked into the relation between intestinal metaplasia and dysplasia. In this study 75 cholecystectomized materials were examined and checked for the premalignant epithelial changes.

Seventy five cholecystectomized patients with history of chronic cholecystitis and cholelithiasis were put into three groups of equal size-25 each. A single sample when taken from each neck-corpus and fundus of the gallbladder in the first group, two samples were taken from each site in the second group. In the last group the gallbladder was mapped and examined as a whole. Hematoxylineosin (HE), neutral mucin (to signify mucin profile histochemically), PAS-Alcian blue (pH 2.5) and High-Iron- Diamine (HID) (pH 2.5) were used in all biopsy samples. In all samples we looked into the existence and type of pseudopyloric gland metaplasia, intestinal metaplasia, dysplasia, hyperplasia and inflammation.

By increasing the sample size in gallbladder we saw an increase in the rate of metaplasia (p<0.001), dysplasia (p<0.001), epithelial hyperplasia (p=0.003), and inflammation (p=0.003) statistically. As the inflammation increases the incidence of metaplasia (p<0.001) and epithelial hyperplasia (p=0.002) were also increasing. There was no significance association between metaplasia and dysplasia.

Given these findings, increasing the sample size in cholecystectomy materials- being the most common specimens in daily pathology routines will increase the diagnosis rates of metaplasia, dysplasia and early carcinoma significantly.