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| Width = | | Width = | ||
| Caption = Gallbladder with intestinal metaplasia. [[H&E stain]]. | | Caption = Gallbladder with intestinal metaplasia. [[H&E stain]]. | ||
| Micro = | | Micro = gallbladder mucosa with goblet cells +/-Paneth cells | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = gallbladder | | LMDDx = [[gallbladder dysplasia]], [[gallbladder carcinoma]] | ||
| Stains = [[Alcian blue stain]] +ve | | Stains = [[Alcian blue stain]] +ve | ||
| IHC = | | IHC = | ||
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| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = | | Gross = | ||
| Grossing = | | Grossing = [[Gallbladder grossing]] | ||
| Site = [[gallbladder]] | | Site = [[gallbladder]] | ||
| Assdx = [[chronic cholecystitis]] | | Assdx = [[chronic cholecystitis]] | ||
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| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = benign, increased risk of carcinoma | | Prognosis = benign, increased risk of [[gallbladder carcinoma|carcinoma]] | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
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It is also known as '''gallbladder [[intestinal metaplasia]]'''. | It is also known as '''gallbladder [[intestinal metaplasia]]'''. | ||
==General== | ==General== | ||
*Associated with [[chronic cholecystitis]].<ref name=pmid11702256>{{Cite journal | last1 = Sai | first1 = K. | last2 = Kajiwara | first2 = H. | title = An immunohistochemical study of metaplastic endocrine cells in human gallbladder cancer. | journal = J Hepatobiliary Pancreat Surg | volume = 8 | issue = 5 | pages = 453-60 | month = | year = 2001 | doi = | PMID = 11702256 }} | |||
</ref> | |||
**Not associated with [[acute cholecystitis]]. | |||
Significance: | Significance: | ||
*Increased risk of carcinoma.<ref name=pmid8364865>{{Cite journal | last1 = Duarte | first1 = I. | last2 = Llanos | first2 = O. | last3 = Domke | first3 = H. | last4 = Harz | first4 = C. | last5 = Valdivieso | first5 = V. | title = Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution, and probability of detection in routine histologic samples. | journal = Cancer | volume = 72 | issue = 6 | pages = 1878-84 | month = Sep | year = 1993 | doi = | PMID = 8364865 }}</ref> | *Increased risk of carcinoma.<ref name=pmid8364865>{{Cite journal | last1 = Duarte | first1 = I. | last2 = Llanos | first2 = O. | last3 = Domke | first3 = H. | last4 = Harz | first4 = C. | last5 = Valdivieso | first5 = V. | title = Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution, and probability of detection in routine histologic samples. | journal = Cancer | volume = 72 | issue = 6 | pages = 1878-84 | month = Sep | year = 1993 | doi = | PMID = 8364865 }}</ref> | ||
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==Gross== | ==Gross== | ||
*No specific changes. | *No specific changes. | ||
Notes: | |||
*Usually seen in the context of chronic cholecystitis if isolated. | |||
==Microscopic== | ==Microscopic== | ||
Features:<ref name=pmid2872152>{{Cite journal | last1 = Albores-Saavedra | first1 = J. | last2 = Nadji | first2 = M. | last3 = Henson | first3 = DE. | last4 = Ziegels-Weissman | first4 = J. | last5 = Mones | first5 = JM. | title = Intestinal metaplasia of the gallbladder: a morphologic and immunocytochemical study. | journal = Hum Pathol | volume = 17 | issue = 6 | pages = 614-20 | month = Jun | year = 1986 | doi = | PMID = 2872152 }}</ref> | Features:<ref name=pmid2872152>{{Cite journal | last1 = Albores-Saavedra | first1 = J. | last2 = Nadji | first2 = M. | last3 = Henson | first3 = DE. | last4 = Ziegels-Weissman | first4 = J. | last5 = Mones | first5 = JM. | title = Intestinal metaplasia of the gallbladder: a morphologic and immunocytochemical study. | journal = Hum Pathol | volume = 17 | issue = 6 | pages = 614-20 | month = Jun | year = 1986 | doi = | PMID = 2872152 }}</ref> | ||
*[[Goblet cell]]s - '''key feature'''. | *[[Goblet cell]]s - '''key feature'''. | ||
*+/-Paneth | *+/-[[Paneth cell]]s.<ref name=Ref_Sternberg4_1789>{{Ref Sternberg4|1789}}</ref> | ||
Notes: | |||
*Often accompanied by antral type metplasia. | *Often accompanied by antral type metplasia. | ||
**Gastric antral-type epithelium - may form glands. | **Gastric antral-type epithelium - may form glands. | ||
*Gallbladders with intestinal metaplasia do ''not'' have to be [[submitted in total]].<ref name=uscap2017_akki>Akki ''et al.'' (2017) "Detecting Incidental Gallbladder Adenocarcinoma: When to Submit the Entire Gallbladder". Available at: [http://www.abstracts2view.com/uscap17/view.php?nu=USCAP17L_2016 http://www.abstracts2view.com/uscap17/view.php?nu=USCAP17L_2016]. United States and Canadian Academy of Pathology Annual Meeting. Accessed on: April 9, 2017.</ref> | |||
DDx: | DDx: | ||
*[[Gallbladder adenocarcinoma]]. | *[[Gallbladder adenocarcinoma]]. | ||
*[[Gallbladder adenoma]] (gallbladder dysplasia). | |||
===Images=== | ===Images=== | ||
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</gallery> | </gallery> | ||
www: | www: | ||
*[http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-129-3-386-f01&doi=10.1043%2F1543-2165%282005%29129%3C386%3APPOGDA%3E2.0.CO%3B2 IM - among other things (archivesofpathology.org)].<ref name=pmid15737036/> | *[http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-129-3-386-f01&doi=10.1043%2F1543-2165%282005%29129%3C386%3APPOGDA%3E2.0.CO%3B2 IM - among other things (archivesofpathology.org)].<ref name=pmid15737036>{{Cite journal | last1 = Mukhopadhyay | first1 = S. | last2 = Landas | first2 = SK. | title = Putative precursors of gallbladder dysplasia: a review of 400 routinely resected specimens. | journal = Arch Pathol Lab Med | volume = 129 | issue = 3 | pages = 386-90 | month = Mar | year = 2005 | doi = 10.1043/1543-2165(2005)129386:PPOGDA2.0.CO;2 | PMID = 15737036 }}</ref> | ||
==Stains== | |||
*Alcian blue/PAS +ve. | |||
==Sign out== | ==Sign out== | ||
<pre> | |||
Gallbladder, Cholecystectomy: | |||
- Gallbladder wall with focal intestinal metaplasia and mild chronic inflammation. | |||
- Cholelithiasis. | |||
- NEGATIVE for dysplasia. | |||
</pre> | |||
===Block letters=== | |||
<pre> | <pre> | ||
GALLBLADDER, CHOLECYSTECTOMY: | GALLBLADDER, CHOLECYSTECTOMY: | ||
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- NEGATIVE FOR DYSPLASIA. | - NEGATIVE FOR DYSPLASIA. | ||
</pre> | </pre> | ||
===Micro=== | |||
The sections show gallbladder wall with mild chronic inflammation and entrapped epithelial | |||
crypts, that focally extend through the muscularis. The entrapped deep crypts have no | |||
apparent nuclear atypia, and no apparent mitotic activity. | |||
A very small focus of intestinal metaplasia is present in the surface epithelium. No dysplasia is identified. | |||
==See also== | ==See also== |
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