Early cancer of the gallbladder and coexistent changes in the mucosa
Urban, A.; Papla, B.
Patologia Polska 35(2): 137-152
1984
ISSN/ISBN: 0031-3114 PMID: 6514417 Document Number: 230774
The histological structure of 18 carcinomas of the gallbladder with infiltration confined to the tunica muscularis was studied on the basis of the changes found in the mucosa surrounding the organ. The frequent concurrence of cancer and inflammation of the mucosa (in 100% of cases), epithelial hyperplasia (68.7%), metaplasia (68.7%) and dysplasia (87.5%) was shown. Epithelial hyperplasia most often assumed a flat rather than the papillary form noted in connection with papillary adenocarcinoma. In 3 cases adenocarcinoma showed a connection with adenoma. Dysplasia was among the most frequent changes in the mucosa in the vicinity of the cancer, and its intensified stage (dysplasia majoris gradus) was characterized by a close resemblance to the picture of intraepithelial cancer (carcinoma in situ). These studies suggest that inflammation of the gallbladder and the regeneration following this may form a substrate for epithelial hyperplasia succeeded by metaplastic change and dysplasia, which bear features of a precancerous change. Early cancer of the gallbladder took a clinical course with symptoms characteristic of inflammation and/or calculi. The advanced average age of patients with early cancer, nearly the average age of patients with advanced cancer, may suggest the rapid progress of the neoplastic process, facilitated by the features of the anatomical construction of the gallbladder. Early cancers constituted 4.9% of the cancers of the gallbladder investigated in the surgical material.