[Dysplasia of the gallbladder].

Out of 2,027 resected gallbladders that were examined, 46 (2.2%) manifested dysplasia and, to study this further, step sections, 5 mm apart, were performed. The average age of these dysplastic cases was 63.8 years, with a male to female ratio of 1:3. The most frequent dysplastic sites in the gallbladder were in the fundus and the body. Excluding adenomas, polypoid lesions, the dysplasia appeared flat, granular, or irregular. As to diameter, 68.6% were within 1 cm, and 89% were no more than 2 cm. The majority of cases manifesting mild dysplasia had lesions of up to 5 mm in size while the lesions seen in moderate cases were within 2 cm. Stones were found in 80.4% of the cases, and incidences of intestinal metaplasia and pseudopyloric gland metaplasia were found in 80.4% and 100% of these cases, respectively. Incidences of dysplasia adjacent to the carcinoma was seen in 41.8% of the cases, and frequently found in early-stage lesions and well-differentiated carcinomas. Our findings have led us to believe that recognition of the intestinal metaplasia-dysplasia-carcinoma sequence is important.