Fifty three surgically resected gallbladders(49 cases of chronic cholecystitis with or
without cholelithiasis, 4 cases of incidentally resected gallbladders) and 14 autopsy cases
were subjected to the histotopographic analysis to identify the nature and distribution of
metaplastic mucosal changes, and to determine the possible histogenesis of these
mucosal lesions and diagnostic implication as a parameter of chronic cholecystitis.
1) Antral type glands were demonstrated in 47(88.7%), goblet cells in 19(35.8%) and
surface epithelial changes In 27(50.9%) of total surgical specimens, indicating the benign
metaplastic changes of the gallbladder mucosa toward the gastric or intestinal type.
2) Topographic distribution illustrated the extension of antral type gland to the middle
and upper one third portions of the gallbladder mucosa in 37 cases, each. Goblet cells in
the middle and upper one third of the mucosa were demonstrable in 13 cases(68%) and
8 cases(42%), respectively.
3) Average age by degree of extension was 50.0 years in Grade O-I, 50.1 years in
Grade Ⅱ and 56.4 years in Grade Ⅲ.
4) Among 53 surgically resected gallbladders, gallstone was found in 31 cases, in
which was a significant correlation between the distribution of metaplastic changes by
degree of extent and cholelithiasis.
5) There was no statistical significance between incidence of metaplastic changes of
the gallbladder and degree of inflammatory reaction by means of chronic and/or acute
inflammatory cell infiltration and Rokitansky-Aschoff ainus formation.
6) Only two out of fourteen autopsy cases demonstrated focal and spotty presence of
goblet cells.
It is of authors assumption that the lining epithelium of the gallbladder undergoes
various types of metaplastic changes in the diseased conditions, in which cholelithiasis is
included as one of preceding factor. And also, the diagnostic implication of epithelial
metaplasia as an expression of chronic cholecystitis is discussed.
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