Early carcinoma of the gallbladder.

The material consisted of 12 gallbladder carcinomas, all in their early phases. Ten of the patients were female, two were male. The mean age of the patients was 65 years, and the mean lifetime after operation was as short as five months. The purpose of this study was to obtain further information on the significance of metaplastic mucosal islands in the histogenesis of gallbladder carcinomas by investigating incipient carcinomas and the conditions of the adjacent mucosa. The investigation revealed goblet cells and enterochromaffin cells outside the tumour in four specimens, antral-type glands in ten specimens, gastric-type superficial epithelial islands in all twelve specimens. In eight cases there was an antral-type mucosal island outside the tumour. In six specimens the tumour was found to border on antral-type mucosa. The structure of the tumour was papillary in ten cases, and mucinous in two. The tumorous epithelium showed in all specimens focal intestinal-type areas. Six tumours displayed goblet cells, and enterochromaffin cells were present in four tumours. The two mucinous tumours seemed to have originated in the glands of the antral-type mucosa extending toward the serosal surface of the gallbladder wall. This study supports the theory suggesting a significance of metaplasia in the histogenesis of gallbladder tumours.