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Gallbladder

Dysplasia

Dysplasia-general

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 10 February 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● 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)


Table: dysplasia and intestinal metaplasia

Gross description
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● Granular mucosal patches or no gross findings

Micro description
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● 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

Micro images
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Various images

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

End of Gallbladder > Dysplasia > Dysplasia-general

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