Madiha Sajjad, Rehan Ahmed Khan, Samina Iltaf.
Microscopic assessment of macroscopically normal gall bladder specimens: is it worth the trouble?.
Rawal Med J Jan ;37(2):172-5.

Objectives: To assess that the histologic examination of macroscopically normal looking gallbladder specimens is really needed. Methods: This descriptive study was carried out at IIMCT-Railway General hospital, Rawalpindi from January 2006 to December 2010. All cholecystectomy specimens submitted to the department of histopathology during a five years period, were included in the study. The total number of blocks submitted was 400 (average 1.2 blocks/ specimen). The reports were retrieved by computer search. The clinical history provided on the specimen request form was noted. Further notes were retrieved in cases of malignancy to evaluate preoperative ultrasound and intraoperative findings. Macroscopic findings by a consultant pathologist were recorded from the reports. The microscopic findings were reassessed by two pathologists independently, to determine whether any lesions of clinical importance were present. Results: A total of 326 gallbladder specimens were submitted for histopathological examination within the study period. Twenty seven percent (n=88) were males and 73 % (n=238) were females with age range of 54-80 years (average 62 years). Chronic cholecystitis was the most common finding in 84.7% of cases (n=276), followed by acute cholecystitis in 14.7% (n=48). Only two of the gall bladders showed adenocarcinoma (0.6%), which was preoperatively diagnosed on ultrasound findings and suspected on gross/macroscopic examination. Conclusions: Microscopic assessment of macroscopically normal cholecystectomy specimens does not contribute to patient management and a more selective approach should be considered. This will reduce the burden on pathology departments, along with considerable cost containment. (Rawal Med J 2012:37:172-175).

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