Türk Patoloji Dergisi (Jan 2018)

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,
  • F. Göknur Akarca,
  • Serdar Balcı,
  • Asuman Argon,
  • Selma Şengiz Erhan,
  • Nesrin Turhan,
  • Neslihan İnce Zengin,
  • Sevinç Hallaç Keser,
  • Betül Çelik,
  • Tangül Bulut,
  • Samir Abdullazade,
  • Esra Erden,
  • Berna Savaş,
  • Temmuz Bostan,
  • Özgül Sağol,
  • Anıl Aysal Ağalar,
  • Nuray Kepil,
  • Yıldırım Karslıoğlu,
  • Armağan Günal,
  • Fatma Markoç,
  • Burcu Saka,
  • Gonca Özgün,
  • Şükrü Oğuz Özdamar,
  • Burak Bahadır,
  • Esin Kaymaz,
  • Emre Işık,
  • Semin Ayhan,
  • Deniz Tunçel,
  • Banu Özgüven Yılmaz,
  • Sevinç Çelik,
  • Tuba Karabacak,
  • İpek Erbarut Seven,
  • Çiğdem Ataizi Çelikel,
  • Zuhal Gücin,
  • Özgür Ekinci,
  • Gülen Akyol

DOI
https://doi.org/10.5146/tjpath.2017.01404
Journal volume & issue
Vol. 34, no. 1
pp. 41 – 48

Abstract

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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.

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