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Kolesistektomi Spesmenlerimizin Histopatolojik Sonuçları ve Malignite Sıklığı

Yıl 2017, Cilt: 1 Sayı: 3, 107 - 111, 18.12.2017

Öz

Amaç:
Kolesistektomi uygulanan olgularda safra kesesi hastalıklarının dağılımını
belirlemek.

Yöntemler: Hastanemizde Temmuz 2015-Temmuz 2016
tarihleri arasında herhangi bir nedenle
kolesistektomi
uygulanan toplam 116 olguya ait kolesistektomi materyalinin histopatolojik
özellikleri gözden geçirildi. Olguların raporları
yeniden değerlendirildi.

Bulgular: Çalışmaya 87’si (%75) kadın, 29’u (%25) erkek olmak üzere toplam 116 olgu
alındı. Olguların yaş aralığı 20-82, yaş ortalaması 50,98±15,28 idi. En çok
rastlanan hastalıklar 108 olguda görülen kronik kolesistit ve 62 olguda görülen
kolelitiazisdi. Ksantogranulomatöz kolesistitli iki olgumuzda safra kesesi
intraoperatif olarak malignite açısından kuşkulu bulunmuştur. On yedi olguda
metaplazi, üç olguda displazi ve iki olguda insidental olarak adenokarsinom
tespit edildi.







Sonuç: Kolesistektomi
uygulanan olgularda safra kesesinde malign tümör insidansı düşüktür (%1,72).
Klinik olarak bulgu göstermeyen malignitelerin saptanabilmesi veya
ksantogranulomatöz kolesistit gibi malignite kuşkusu oluşturan bulguların
ekarte edilmesi için kolesistektomi spesimenlerinin rutin olarak, yeterli
sayıda örnekleme yapılarak histopatolojik incelemeye alınması gerektiğini düşünüyoruz.

Kaynakça

  • 1-Sasatomi E, Tokunaga O, Miyazaki K. Precancerous conditions of gallbladder carcinoma: overview of histopathologic characteristics and molecular genetic findings. J Hepatobiliary Pancreat Surg 2000;7:556-567.
  • 2-Duarte I, Llanos O, Domke H, et al. Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution, and probability of detection in routine histologic samples. Cancer 1973; 72:1878-1884.
  • 3-Lowsiriwat V, Vongjirad A, Lowsiriwat D. Value of routine histopathologic examination of three common surgical specimens: appendix, gallbladder and hemorrhoid. World JSurg 2009; 33:2189-93. doi: 10.1007/s00268-009-0164-6.
  • 4-Zhang WJ, Xu GF, Zou XP, et al. Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg 2009;33:2651-6.
  • 5-Memon W, Khanzada TW, Samad A, Kumar B. Histopathology Spectrum of gallbladder specimens after cholecystectomy. Pak J Med Sci 2011;27: 533-6. 6-Mazlum M, Dilek FH, Yener AN, Tokyol Ç, Aktepe F, Dilek ON. Profile of gallbladder diseases diagnosed at Afyon Kocatepe University: a retrospective study. Turk Patoloji Derg 2011;27:23-30.
  • 7-Adsay NV. Gallbladder, extrahepatic biliary tree, and ampulla. In: Mills SE, Carter D, Greenson JK, Reuter VE, Stoler MH, editors. Sternberg’s Diagnostic Surgical Pathology. Vol 2.5th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2010:1600-51.
  • 8-Jagannath SB, Singh VK, Cruz-Correa M, Canto MI, Kalloo AN. A long-term cohort study of outcome after cholecystectomy for chronic acalculous cholecystitis. Am J Sur 2003;185:91-5.
  • 9-Hatae Y, Kikuchi M. Lymph follicular cholecystitis. Acta Pathol Jpn1979;29:67-72.
  • 10-Hepburn A, Coady A, Livingstone J, Pandit N. Eosinophilic cholecystitis as a possible late manifestation of the eosinophiliamyalgia syndrome. Clin Rheumatol 2000;19:470-2.
  • 11-Choudhury M, Pujani M, Katiyar Y, Jyotsna PL, Rautela A. Idiopathic eosinophilic cholecystitis with cholelithiasis: a report of two cases. Turk Patoloji Derg 2014;30:142-4. doi:10.5146/tjpath.2014.01235.
  • 12-Ishii T, Hatano E, Yasuchika K, et al. A case xanthogranulomatous cholecystitis suspected to be adenocarcinoma based on the intraoperative peritoneal washing cytology. Int J Surg Case Rep 2014;5:138-41. doi: 10.1016/j.ijscr.2014.01.011.
  • 13-Sandri L, Colecchia A, Larocca A, et al. Gallbladder cholesterol polyps and cholesterolosis. Minerva Gastroenterol Dietol 2003;49:217-24.
  • 14-Kroh M, Chalikonda S, Chand B, Walsh M. Laparoscopic completion cholecystectomy and common bile duct exploration for retained gallbladder after single-incision cholecystectomy. JSLS 2013;17:143-7. doi: 10.4293/108680 812X13517013317356.
  • 15-Liew PL, Wang W, Lee YC, et al. Gallbladder Diseas Among Obese Patient in Taiwan. Obes Surg. 2007 Mar; 17(3): 383-90.
  • 16- Caselli M, Aleotti A, Novarra G, et al. Cholesterol Vesicles in Areas of Gastric Metaplasia of Gallbladder Epithelium. J Submicrosc Cytol Pathol. 1996 Apr;28(2): 251-3.
  • 17-Buitrago Salassa C, Javier Lespi P. Detection of acid mucins in gastric metaplasia of the gallbladder. Acta Gastroenterol Latinoam. 2007 Mar;37(1):11-4.
  • 18-Wistuba II, Gazdar AF, Roa I, et al. p53 protein overexpression in gallbladder carcinoma and its precursor lesions: an immunohistochemical study. Hum Pathol 1996;27:360-365.
  • 19-Albores-Saavedra J, Vardaman CJ, Vuitch F. Non-neoplastic polypoid lesions and adenomas of the gallbladder. Pathol Annu 1993;28:145-177. 20-Hundal R, Shaffer EA. Gallbladder cancer: epidemiology and outcome. Clin Epidemiol 2014;6:99-109.
  • 21-Albores-Saavedra J, Kloppel G, Adsay NV, et al. Carcinoma of the gallbladder and extrahepatic bile ducts In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO Classification of Tumors of the Digestive System. 4th ed. Lyon:IARC Press, 2010:266-73.

Histopathologic Results of Our Colesystectomy Specimens and Malignancy Frequency

Yıl 2017, Cilt: 1 Sayı: 3, 107 - 111, 18.12.2017

Öz

Aim: To determine
the distribution of gall bladder diseases in cholecystectomy cases.

 

Methods: Histopathologic features
of cholecystectomy specimens from 116 cases, who underwent cholecystectomy
between the dates July 2015 and July 2016, were reviewed.
The
reports of the cases were re-evaluated.

 

Findings: A total of
116 cases, 87 (75%) female and 29 (25%) male, were included in the study. Their
age ranged from 20 to 82, and the mean age was found as 50,98 ± 15,28. The most commonly seen diseases were chronic
cholecystitis, present in 108 of the cases, and cholelithiasis, seen in 62 of
them. In our two xanthogranulomatous cholecystitis cases gall bladder was
suspected intraoperatively for malignancy. Metaplasia, dysplasia and incidental adenocarcinoma was detected in 17, 3
and 2 of the cases respectively.

 













Results: The incidence
of malignant gallbladder tumors is low in patients undergoing cholecystectomy (%1,72).
In order to detect clinically asymptomatic malignancies or to exclude the cases
which create malignancy suspect such as xanthogranulomatous cholecystitis, we
think sufficient numbers of sampling and histopathological examinations are
needed. 

Kaynakça

  • 1-Sasatomi E, Tokunaga O, Miyazaki K. Precancerous conditions of gallbladder carcinoma: overview of histopathologic characteristics and molecular genetic findings. J Hepatobiliary Pancreat Surg 2000;7:556-567.
  • 2-Duarte I, Llanos O, Domke H, et al. Metaplasia and precursor lesions of gallbladder carcinoma. Frequency, distribution, and probability of detection in routine histologic samples. Cancer 1973; 72:1878-1884.
  • 3-Lowsiriwat V, Vongjirad A, Lowsiriwat D. Value of routine histopathologic examination of three common surgical specimens: appendix, gallbladder and hemorrhoid. World JSurg 2009; 33:2189-93. doi: 10.1007/s00268-009-0164-6.
  • 4-Zhang WJ, Xu GF, Zou XP, et al. Incidental gallbladder carcinoma diagnosed during or after laparoscopic cholecystectomy. World J Surg 2009;33:2651-6.
  • 5-Memon W, Khanzada TW, Samad A, Kumar B. Histopathology Spectrum of gallbladder specimens after cholecystectomy. Pak J Med Sci 2011;27: 533-6. 6-Mazlum M, Dilek FH, Yener AN, Tokyol Ç, Aktepe F, Dilek ON. Profile of gallbladder diseases diagnosed at Afyon Kocatepe University: a retrospective study. Turk Patoloji Derg 2011;27:23-30.
  • 7-Adsay NV. Gallbladder, extrahepatic biliary tree, and ampulla. In: Mills SE, Carter D, Greenson JK, Reuter VE, Stoler MH, editors. Sternberg’s Diagnostic Surgical Pathology. Vol 2.5th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2010:1600-51.
  • 8-Jagannath SB, Singh VK, Cruz-Correa M, Canto MI, Kalloo AN. A long-term cohort study of outcome after cholecystectomy for chronic acalculous cholecystitis. Am J Sur 2003;185:91-5.
  • 9-Hatae Y, Kikuchi M. Lymph follicular cholecystitis. Acta Pathol Jpn1979;29:67-72.
  • 10-Hepburn A, Coady A, Livingstone J, Pandit N. Eosinophilic cholecystitis as a possible late manifestation of the eosinophiliamyalgia syndrome. Clin Rheumatol 2000;19:470-2.
  • 11-Choudhury M, Pujani M, Katiyar Y, Jyotsna PL, Rautela A. Idiopathic eosinophilic cholecystitis with cholelithiasis: a report of two cases. Turk Patoloji Derg 2014;30:142-4. doi:10.5146/tjpath.2014.01235.
  • 12-Ishii T, Hatano E, Yasuchika K, et al. A case xanthogranulomatous cholecystitis suspected to be adenocarcinoma based on the intraoperative peritoneal washing cytology. Int J Surg Case Rep 2014;5:138-41. doi: 10.1016/j.ijscr.2014.01.011.
  • 13-Sandri L, Colecchia A, Larocca A, et al. Gallbladder cholesterol polyps and cholesterolosis. Minerva Gastroenterol Dietol 2003;49:217-24.
  • 14-Kroh M, Chalikonda S, Chand B, Walsh M. Laparoscopic completion cholecystectomy and common bile duct exploration for retained gallbladder after single-incision cholecystectomy. JSLS 2013;17:143-7. doi: 10.4293/108680 812X13517013317356.
  • 15-Liew PL, Wang W, Lee YC, et al. Gallbladder Diseas Among Obese Patient in Taiwan. Obes Surg. 2007 Mar; 17(3): 383-90.
  • 16- Caselli M, Aleotti A, Novarra G, et al. Cholesterol Vesicles in Areas of Gastric Metaplasia of Gallbladder Epithelium. J Submicrosc Cytol Pathol. 1996 Apr;28(2): 251-3.
  • 17-Buitrago Salassa C, Javier Lespi P. Detection of acid mucins in gastric metaplasia of the gallbladder. Acta Gastroenterol Latinoam. 2007 Mar;37(1):11-4.
  • 18-Wistuba II, Gazdar AF, Roa I, et al. p53 protein overexpression in gallbladder carcinoma and its precursor lesions: an immunohistochemical study. Hum Pathol 1996;27:360-365.
  • 19-Albores-Saavedra J, Vardaman CJ, Vuitch F. Non-neoplastic polypoid lesions and adenomas of the gallbladder. Pathol Annu 1993;28:145-177. 20-Hundal R, Shaffer EA. Gallbladder cancer: epidemiology and outcome. Clin Epidemiol 2014;6:99-109.
  • 21-Albores-Saavedra J, Kloppel G, Adsay NV, et al. Carcinoma of the gallbladder and extrahepatic bile ducts In: Bosman FT, Carneiro F, Hruban RH, Theise ND, editors. WHO Classification of Tumors of the Digestive System. 4th ed. Lyon:IARC Press, 2010:266-73.
Toplam 19 adet kaynakça vardır.

Ayrıntılar

Konular Klinik Tıp Bilimleri
Bölüm MAKALELER
Yazarlar

Gülay Turan 0000-0002-3702-8811

Figen Aslan

Eren Altun 0000-0001-9110-8364

Yayımlanma Tarihi 18 Aralık 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 1 Sayı: 3

Kaynak Göster

APA Turan, G., Aslan, F., & Altun, E. (2017). Kolesistektomi Spesmenlerimizin Histopatolojik Sonuçları ve Malignite Sıklığı. Balıkesir Medical Journal, 1(3), 107-111.