Sherwani R, Akhtar K, Zaheer S, Tuli P

The study was undertaken to study the precursor lesions of invasive gall bladder carcinoma by FNAC and impression cytology and correlate it with histology. A total of 140 patients with sign and symptoms of gall bladder disease were divided into 2 groups. Group-A included 30 patients with USG confirmed cancer in whom only FNAC was performed. Group-B included the remaining 110 patients. After cholecystectomy, bile was immediately drained off and 2-3 imprint smears prepared and stained with H&E and papanicolaou stain. The specimen was then processed histopathologically and sections stained with H&E. The commonest lesion observed was chronic cholecystitis with cholelithiasis (74.5%). Well differentiated adenocarcinoma (84.8%) was the most frequent type of gall bladder carcinoma. Fundus was the commonest site for all precursor lesions. Most cases of simple hyperplasia was seen in the 3rd and 4th decades of life (67.9%). 70% of cases of atypical hyperplasia and carcinoma in situ were observed in the 4th and 5th decades. A good cytohistologic correlation was obtained in cases of carcinoma in situ (66.7%) and invasive carcinoma (100%). Precancerous lesions of gall bladder carcinoma can be identified better by cytologic means than through random histologic sections.

Key word : gall bladder carcinoma, precursor lesions, impression smears