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Gallbladder Pathology Online

Pathology of Dysplasia and Carcinoma in situ of the Gallbladder

Dr Sampurna Roy MD


Syn: Atypical Hyperplasia of the gallbladder

Dysplasia of the gallbladder epithelium is characterized by pseudostratification and disorganization of the lining epithelium.

The cells show hyperchromatism, nuclear crowding, loss of cellular polarity and increased mitotic activity.

The dysplastic changes may be seen in flat mucosa or there may be small papillary projections.


Microscopic images of gallbladder mucosa showing dysplastic changes. Small papillary projections are present.

Microscopic images of flat gallbladder mucosa showing dysplastic changes.


Most cases of gallbladder adenocarcinoma are preceded by intestinal metaplasia, dysplasia (atypical hyperplasia) and carcinoma in situ.

In the presence of dysplastic changes of the gallbladder epithelium, the histopathologist should carefully examine the specimen to rule out any foci of invasive carcinoma.

Metaplastic changes (intestinal and gastric types) may be present in the gallbladder mucosa adjacent to dysplastic epithelium and in invasive adenocarcinoma of the gallbladder.

The term carcinoma in situ is used to describe severe atypical changes of the lining epithelial cells of an adenomatous polyp in the absence of stalk invasion.


Further reading:

Predictive factors for incidental gallbladder dysplasia and carcinoma.

Metaplastic changes in chronic cholecystitis: implications for early diagnosis and surgical intervention to prevent the gallbladder metaplasia-dysplasia-carcinoma sequence

A different perspective on macroscopic sampling of cholecystectomy specimens.

Caveat emptor: submitting the entire gallbladder in cases of dysplasia is not justified.

Heterotopic gastric mucosa with mild dysplasia in the gallbladder.

Large villous adenoma of gallbladder: A case report

High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy.









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