Özet

Objective: As there is a continuing issue of 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.

Materials and Method: With the participation of 22 institutions around Turkey which were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The number of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia
was identified with the review of pathology reports and the regional and country-wide rate of incidence was presented in percentages.

Results: It was found that epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of those epithelial lesions, 7% was 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, 15.6% as intestinal metaplasia. Remaining lesions (63%) included primarily non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. Also, there were differences about this subject among the pathology laboratories.

Conclusions: The major causes of the difference in reporting of 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.