The precursor lesions of invasive gallbladder carcinoma. Hyperplasia, atypical hyperplasia and carcinoma in situ

Abstract

In 200 consecutive cholecystectomy specimens excised for cholelithiasis or cholecystitis, 83% exhibited epithelial hyperplasia, 13.5%, atypical hyperplasia and 3.5%, carcinoma in situ. Carcinoma in situ was also observed in the mucosa adjacent to invasive carcinomas in 79% of 39 evaluable surgical cases and in 52.9% of 17 autopsy cases. Our findings suggest that a small number of hyperplasias of the gallbladder evolve toward atypical hyperplasia and that this progresses to in situ carcinoma which finally becomes invasive carcinoma. A simple cytologic technique is recommended for the diagnosis of atypical hyperplasia and carcinoma in situ in excised gallbladders. Preoperative identification of these two lesions in high‐risk patients as well as comments on 156 invasive carcinomas are presented. Copyright © 1980 American Cancer Society