SPECTRUM OF HISTOPATHOLOGICAL FINDINGS IN CHOLECYSTECTOMY SPECIMENS WITH SPECIAL REFERENCE TO CARCINOMA OF GALLBLADDER – A 5-YEAR RETROSPECTIVE STUDY

Background: Cholecystectomy is one of the most frequently performed abdominal surgeries worldwide for symptomatic gallstones and inflammatory gallbladder lesions. Routine histopathological examination remains the gold standard for detection of inflammatory, premalignant and malignant lesions, while immunohistochemistry is reserved for selected diagnostically challenging malignant cases. Objective: To analyze the spectrum of histopathological lesions in cholecystectomy specimens and to perform detailed histopathological and immunohistochemical analysis of gallbladder carcinoma cases. Materials and Methods: This retrospective cross-sectional record-based study included all cholecystectomy specimens received over a 5-year period from 1st June 2019 to 31st May 2024. Histopathology records, gross descriptions, and microscopic slides were reviewed. Cases with incomplete records or autolyzed specimens were excluded. Missing clinicodemographic or gross data fields were recorded as unavailable and excluded from variable-specific analysis without excluding the case from overall histopathological spectrum analysis. Statistical analysis included Chi-square test and comparative clinicopathological correlation. Results: Among 2063 specimens, chronic cholecystitis was the most common lesion followed by cholesterolosis, acute on chronic cholecystitis and carcinoma gallbladder. Female predominance was observed in both overall lesions and carcinoma cases. Gallstones were significantly associated with carcinoma gallbladder. Premalignant lesions including dysplasia, intestinal metaplasia and ICPN (Intracholecystic papillary neoplasm) were also identified. A substantial proportion of carcinoma cases were incidental on microscopy without obvious gross growth. Conclusion: Routine gross and microscopic evaluation of all cholecystectomy specimens is essential for detecting incidental carcinoma and premalignant lesions. Immunohistochemistry serves as an adjunct in selected difficult malignant cases.