scholarly journals Importance of Routine Histopathological Examination of Gallbladder Specimen in Detecting Incidental Malignancies

2016 ◽  
Vol 4 (1) ◽  
pp. 15
Author(s):  
Archana Tiwari ◽  
Ramji Rai ◽  
Surendra Kumar Jain

Introduction: Gallbladder carcinoma is the most common cancer of biliary tree and the 5th most common gastrointestinal malignancy.  An early diagnosis is essential as this malignancy progresses silently with a late diagnosis and poor prognosis. Epidemiological studies have identified striking geographic and ethnic variation with high occurrence in Southeast Asia, yet low elsewhere in the world. Gallbladder carcinoma, in 15-30% of patients, show  no preoperative  or intraoperative evidence and are detected only on histopathological examination. They are called as incidental gallbladder cancer (IGBC). The objective of this study was to find out the occurrence of IGBC in cholecystectomy specimens received in our histopathology laboratory and to analyze their clinico-pathological features.   Methods: This was a prospective study carried out in the Department of Histopathology, Lumbini Medical College Teaching Hospital during a period of two years from May 2014 to April 2016. The study included 800 cases of cholecystectomized Gall bladder specimens.   Result: Ninety seven percent of the specimens (n=776) revealed benign pathology. Malignancy was detected incidentally in 8 cases (1.25%). The mean age of patients with incidental Gall bladder carcinoma was 69 years (SD=4.1) and F:M ratio was 9:1. Out of 10 incidental malignancies, cholelithiesis was found in 8 (80%) cases. Fundus was the most common location (n=5, 50%) and focal fragile necrotic area was most common (n=3, 30%) gross morphology. On pathological staging, all the incidentally detected malignancies (n=10) were found to be in surgically resectable stages.   Conclusion: IGBC was found in 1.25% of the gallbladder specimen. Detailed gross and histopathological examination of gallbladder specimen is mandatory for every cholecystectomy specimen, even for benign diseases, to detect incidental carcinoma at potentially curable stage.

2020 ◽  
Vol 22 (4) ◽  
pp. 233-237
Author(s):  
Rakesh Pathak ◽  
M Gupta ◽  
P Poudel ◽  
K Khadka

Gall bladder is one of the important digestive organ which encountered with different histopathological changes. Different changes in dietary habit, obesity, oral contraceptives, alcohal have shows increased pattern of cholecystitis and cholelithiasis and other pathological findings. Detail examination of gall bladder in cholecystectomy specimen helps to evaluate different histopathological pattern of gall bladder lesion and also help to differentiate non-neoplastic from neoplastic lesion and also helps in further management. This was a cross sectional study done in the Department of Pathology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal, during the study of period of six months (Feburary 2020 to July 2020). A total of 127 patients between 16 years to 63 years with mean age of 40.54±10.88 years. There were 127 cholecystectomy specimens were received during study period and out of which 94 were female and 33 were male. On histopathologial evaluation, chronic cholecystitis was most common findings followed by chronic cholecystitis with cholesterolosis. Other findings were chronic cholecystitis with adenomyosis, chronic cholecystitis with pyloric metplasia, chronic cholecystitis with intestinal metpalsia, chronic cholecystitis with polyp, acute on chronic cholecystitis, Xanthogranulomatous cholecytsitis and adenocarcarcinoma . Median age was 40.54 years. It was concluded that Chronic cholecystitis was the most common histopathologcial findings and the common groups was 41-50 years. Routine examination of cholecystectomy specimens grossly and microscopically is important for patient management Though a very few cases of carcinoma of Gall bladder is seen, it is very important to make sure that all cholecystectomy specimens undergone histopathological examination, with this, we can achieve timely diagnosis and early managements.


2019 ◽  
Vol 16 (2) ◽  
pp. 68-70
Author(s):  
K Nahar ◽  
MA Quddus ◽  
KMS Islam ◽  
MA Islam

The objective of the study was to find out the prevalence of gallbladder carcinoma in patients having cholelithiasis. For this purpose a prospective study was carried out on 15 patients of both sexes in Shaheed Ziaur Rahman Medical College Hospital, Bogura. Their mean age was 56 ±8 years (range 30 to 70 years) having gall bladder mass. Gall bladder mass and stone were detected by history, Physical examination, ultrasonography and computed tomography of the abdomen. Carcinoma was confirmed by histopathological examination of specimens removed by operation. All gallbladder masses removed by operation showed malignat tumor on histopathological examination. Among them adenocarcinoma and squamous cell carcinoma were present in 94 and 6 percent respectively. Stones were present within gallbladder mass in 94 percent of cases. In 80 percent of cases the disease was in advanced stage. The results of the present study suggested that the patient having cholelithiasis are prone to develop malignancy in the gallbladder. However as the sample size is small further studies are needed by taking large number of sample to validate this statement Journal of Surgical Sciences (2012) Vol. 16 (2) : 68-70


2019 ◽  
Vol 12 (1) ◽  
pp. 25-30
Author(s):  
B Parajuli ◽  
G Pun ◽  
S Ranabhat ◽  
S Poudel

Objective: To study the spectrum of histopathological diagnosis of endometrial lesions and their distribution according to age. Methods: All the endometrium samples obtained by the procedure of dilatation and curettage and hysterectomy sent for histopathological examination at Pathology Department of Gandaki Medical College Teaching Hospital, Pokhara, Nepal. The study duration was total 12 months ranging from July 2016 to June 2017. All the endometrial samples were processed, sectioned at 4 - 6 μm and stained with routine H & E stain. Patient’s data including age, sex, procedure of the biopsy taken and histopathological diagnosis were noted. A pathologist, using Olympus microscope, reported the slides. Cases were reviewed by a second pathologist whenever necessary. Results: A total of 128 cases were studied. The most common histopathological diagnosis was proliferative endometrium (28.9%) followed by disorder proliferative endometrium (15.65%). Most of the patients were in age group 36 - 45 years comprising 32.03%. Hydatidiform mole comprised of 7.03% and among Hydatidiform mole, partial mole was more common. Dilatation and curettage (82.8%) was the common procedure in compare to hysterectomy for the evaluation of endometrial lesions. Conclusions: In this study, we observed a variety of endometrial lesions. Most of them are benign; among benign, proliferative endometrium was the common histopathological diagnosis followed by disorder proliferative endometrium. Most common presenting age group was found to be at 36 - 45 years. In evaluation of hydatidiform mole, partial mole was more frequent in compare to complete mole. Conventional dilatation and curettage is the preferred method in developing countries with limited resource to screen endometrial lesion and therefore biopsy should be sent for histopathological examination. Thus histopathological examination of routinely stained hematoxylin and eosin is readily available and widely accepted standard technique for evaluation of the endometrial lesions.


2010 ◽  
Vol 17 (01) ◽  
pp. 40-43
Author(s):  
SYED ALI AKBAR ◽  
Mohammad Qasim ◽  
NAZIR AHMED ◽  
Zar Khan ◽  
JOHAR ALI ◽  
...  

Objective: I. To determine the frequency of malignancy in multi nodular goiter. II. To determine the histopathological types.Design: This is a prospective study. Setting: Surgical department of Foundation Hospital Rawalpindi and associated Teaching Hospital ofFrontier Medical College Abbottabad. Period: Aug. 2002 to Aug. 2007. Patients and Methods. One hundred patients with Multi nodular wereincluded in this study. Patient with diffuse goiter, solitary nodules, patient operated somewhere else and suspected cases of malignancy wereexcluded from the study. Tissue were sent to Armed Force Institute for histopathological examination. Patients were followed for 2 weeks aftersurgery with histopathological report, all the preoperative and postoperative findings were recorded in detail. Data was analyzed byusingSPSS 14. Results. Majority of patients studied, belonged to Azad Kashmir and Gilgit which are among the known endemic regions for goitrein Pakistan and other from Chakwal and Jhelum. Histopathology revealed 96 (96%) patients with multi nodular goiter, 3 (3%) papillary carcinomaand 1 (1 %) Follicular carcinoma. Conclusions: Multinodularity of the goitre should not be considered as low risk of malignancy and delay forsurgical intervention. Changes in the size of gland, the appearance of new and hard nodules or cervical lymphadenopathy may indicatemalignant change and prompt indication for surgery.


2018 ◽  
Vol 8 (1) ◽  
pp. 1285-1288
Author(s):  
Sailesh Bahadur Pradhan ◽  
Binita Pradhan ◽  
Sailuja Maharjan ◽  
Prabin Bikram Thapa

Background: Gastrointestinal tract tumour is responsible for more cancers and death than any other cancers.  The tumour in GIT include the tumour of the Oral cavity, Esophagus, Stomach, Colon, Rectum, Liver, Gallbladder, Pancreas and Biliary tree.Materials and methods: A cross sectional study was carried out among all the gastrointestinal tract tumours specimens received for histopathological examination in between January 2016 to June 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital. All tumors diagnosed either benign or malignant were included in this study. Ethical clearance was obtained from the Institutional Review Committee in KMCTH.Results: Colorectum was found to be the most commonly involved site for malignant lesion comprising 40.2% among all malignant lesions followed by stomach comprising 28.6%. Malignancy was found to be more prevalent among male with M:F ratio of 1.6:1 in colorectal region and 1.4:1 in stomach cancers. Regarding benign lesions (polyps), rectum was found to be the commonest site (57.5%), followed by colon (20.0%) and stomach, the least common site.Malignant lesions were more common among the age group of 51-60 years (37.66%) with 70.13% above 50 years. Benign lesions were also found to be the most common above 50 years comprising 40.0 percent.Conclusion: Rectum & colon was found to be the most commonly involved site for both malignant and benign lesion. Malignancy is more prevalent among male and common above 50 years of age. However, malignant cases noted in the adult age group are a matter of great concern.


2014 ◽  
Vol 34 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Bandana Shrestha

Introduction: Undernutrition is a major health problem in developing countries which may have adverse effects on growth and development of an individual. The objectives of this study were to assess the prevalence and grades of malnutrition in children below 60 months of age, attending outpatient department at Gandaki Medical College teaching hospital.Materials and Methods: A prospective study was conducted among 556 children below 60 months of age from August to December 2013. Weight and length/height were measured using standard technique and were plotted on WHO centiles curves and severity determined based on WHO classification. The prevalence of underweight, stunting and wasting were determined by anthropometry.Results: Based on WHO classification, out of 556 children, 20.2% were underweight, 34% were stunted and 15.1% were wasted respectively. Of them, severe underweight were 4.7%, severe stunted were 14.1% and severe wasted were 7.2% respectively.Conclusion: A high prevalence of undernutrition exists in under- five children attending a tertiary hospital in a western region of Nepal.DOI: http://dx.doi.org/10.3126/jnps.v34i2.10566J Nepal Paediatr Soc 2014;34(2):119-124      


2018 ◽  
Vol 5 (2) ◽  
pp. 570
Author(s):  
Vijay Kumar Tekam

Background: Gallbladder carcinoma is not an uncommon clinical entity in the Indian scenario, unlike western countries. It is predominantly a disease of females. Therefore, a female especially in forties and fifties with a history of recent onset of constant pain in the right hypochondrium or change in the character of pain should be thoroughly evaluated. Though the association between gallstones and Gallbladder carcinoma is strong. Therefore, every gallbladder should be subjected to routine histopathological examination because with identification of an early gallbladder carcinoma a curative resection may be possible, and these patients have a good survival rate.Methods: This study is comprising of all patient consecutively admitted for Gall bladder pathology, at Hamidia Hospital, Bhopal, MP during June 2012 to May 2014 on the basis of clinical assessment, USG, FNAC, CT-scan, tumor marker, blood investigation etc.Results: Present study showed that gallbladder cancer is predominantly a disease of elderly females. Commonly, symptoms are related to associated gallstones. In present study, abdominal pain (91.66%) followed by abdominal mass (79.19%) and anorexia (60.16%). In present study, preoperative imaging of the abdomen (both US and CT) showed the presence of gallstones in 38 (79.16%) cases and a mass in the gallbladder was evident in 44 patients (91.66%).Conclusions: Though the association between gallstones and Gallbladder carcinoma is strong, the causal relationship between them is not clear. In spite of the advances made in the field of gallbladder imaging, the detection of carcinoma of the gallbladder in early stages remains low.


2018 ◽  
Vol 1 (1) ◽  
pp. 67-74
Author(s):  
Suspana Hirachand ◽  
RR Sthapit ◽  
P Gurung ◽  
S Pradhanang ◽  
R Thapa ◽  
...  

Background: Upper gastrointestinal tract disorders are one of the most commonly encountered problems in the clinical practice. A variety of disorders can affect the upper gastrointestinal tract. Endoscopy, in combination with biopsy, plays an important role in the exact diagnosis for further management.Objectives: To determine the spectrum of histopathological lesions of upper gastrointestinal tract.Methods: A prospective study was conducted in the Department of Pathology, Kathmandu Medical College and Teaching Hospital, Nepal from January 2015 to December 2016 (2 years).Results: A total 243 endoscopic biopsies were evaluated. Out of which, 219 cases were from gastric, 15 were from esophagus and 9 were from duodenum. Among the gastric biopsies, 77 cases (35.16%) were chronic active gastritis and 27 cases (12.33%) were malignant. The most common malignancy was adenocarcinoma. Among the 15 oesophageal biopsies, 12 cases (80%) were of non-neoplastic and 3 cases (20%) were of neoplastic nature. The most common malignancy was squamous cell carcinoma. Among 9 cases of duodenum biopsies, all were non-neoplastic, of which chronic non-specific duodenitis (66.66%) was the commonest.Conclusion: Endoscopy is incomplete without histopathological examination of biopsy and so, the combinations of methods play an important role in diagnosis and management of upper gastrointestinal tract disorders.Journal of BP Koirala Institute of Health Sciences, Vol. 1, No. 1, 2018, Page: 67-74


2018 ◽  
Vol 3 (2) ◽  
pp. 423-426
Author(s):  
Sailesh Bahadur Pradhan ◽  
Mamata Sedhain ◽  
Sneh Acharya ◽  
Sailuja Maharjan ◽  
Samikchhya Regmi

Introduction: Uterus is subjected to many non-neoplastic and neoplastic diseases. Hysterectomy is the commonest gynecological surgery done for the management of the pathologies of the female reproductive system. Histopathological examination of hysterectomy specimens is done routinely which has both diagnostic and therapeutic significance.Objective: To study the common pathologies identified in hysterectomy specimens and to correlate them with the clinical findings.Methodology: A cross sectional study was carried out among all the hysterectomy specimens irrespective of primary lesion sent for histopathological examination from January 2016 to December 2017 in Department of Pathology, Kathmandu Medical College Teaching Hospital (KMCTH). Relevant history was taken from the requisition form. Ethical clearance was obtained from the Institutional Review Committee of KMCTH.Results: A total of 198 cases were studied. The most common pathology encountered was leiomyoma (60.0%) followed by adenomyosis (14.0%). Atrophic endometrium was seen in 24.3% cases. Chronic cervicitis was found in most of the cases (96.5%) along with endocervical polyp in 8.1% cases. Leiomyoma was found to be the most common indication for hysterectomy comprising 48.0% followed by abnormal uterine bleeding (24.75%) and utero-vaginal prolapse (18.25%). Hysterectomy was most commonly performed in the age group of 41 - 50 years and total abdominal hysterectomy with bilateral salpingo-oophorectomy was found to be the commonest procedure done comprising 8 0.0%.Conclusion: Leiomyoma was found to be the most common pathology in myometrium and chronic cervicitis in cervix. Abnormal uterine bleeding and vaginal prolapsed were also found to be common. Lesions which can be managed conservatively do need hysterectomy or not, is a matter of great concern. BJHS 2018;3(2)6:423-426.


2021 ◽  
Vol 5 (1) ◽  
pp. 60-66
Author(s):  
Pratikchya Karki ◽  
Samir Neupane ◽  
Ashesh Dhungana ◽  
Sumida Tiwari

Introduction: Lung carcinoma is the most common cancer with 2.1 million (11.6%) newly diagnosed cases in 2018. Over the years, many cytotechniques have been developed but their combination with histology is still an area of controversy. Imprint and crush cytology are considered simple, rapid and cost effective for a low resource setting in the early diagnosis and management of lung cancer. Here, we aimed to assess the diagnostic accuracy of imprint and crush cytology and compare them with histopathology.  Method: A prospective study was conducted from May 2017 to April 2018 at the Pulmonary medicine unit and Department of Pathology at National Academy of Medical Sciences (NAMS), Bir Hospital. A total of 53 patients were enrolled in the study who showed visible mass on bronchoscopy. Three to five bits of tissue were obtained, imprint and crush smear were prepared from them and the tissue were then sent for histopathological examination. The level of significance selected was p < 0.005.  Results: The most common age group affected was 60-69 years. 91% cases were smokers, with a male predominance. The most common location of endobronchial growth was left upper lobe. 43 cases were malignant in biopsy. The sensitivity, specificity, accuracy and positive predictive value of imprint cytology was 71.05%, 87.50%, 73.91% and 96.43% respectively while that for crush cytology was 74.36%, 75%, 74.47% and 93.55% respectively. The diagnostic yield of imprint, crush smear and forceps biopsy were 52.8%, 58.4% and 81.1% respectively. Squamous cell carcinoma was the most common carcinoma in this study.  Conclusion: Imprint and crush cytology yield additional information that can be complementary to endobronchial biopsy. They are convenient, do not burden the patients and thus can be carried out wherever possible during bronchoscopy. 


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