Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 6 February 2018, last major update September 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Dysplasia[TI] gallbladder

Cite this page: Gulwani, H. Dysplasia - general. website. Accessed November 14th, 2018.
Definition / general
  • Neoplastic intraepithelial proliferation
  • Present in 1 - 34% of cholecystectomy specimens (severe dysplasia in 1 - 3%)
  • May be associated with invasive carcinoma
  • Diagnose with caution if extensive ulceration or acute inflammation
  • Extensive sampling recommended after diagnosis (can use jelly roll technique used for placentas)
  • Submitting the entire gallbladder in cases of dysplasia is not justified; proper review of the gross specimen and submission of up to 4 additional sections identify all significant lesions (Am J Clin Pathol 2012;138:374)
  • Statistical significant association has been noted between intestinal metaplasia and dysplasia (Gastroenterol Hepatol (N Y) 2008;4:735)
Diagrams / tables

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Table: dysplasia and intestinal metaplasia

Gross description
  • Granular mucosal patches or no gross findings
Microscopic (histologic) description
  • Involves flat mucosa, papillae, Rokitansky-Aschoff sinuses, metaplastic pyloric glands
  • Abrupt transition from normal mucosa
  • May resemble carcinoma but no desmoplasia
  • Often goblet cells
  • Low grade: crowding and hyperchromatic and elongated nuclei
  • High grade: low grade features plus stratification; includes carcinoma in situ
Microscopic (histologic) images

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Various images

Differential diagnosis
  • Reactive epithelial changes: no abrupt transition from normal mucosa, prominent nucleoli, epithelial atypia proportional to stromal atypia