A Comprehensive Exploration of Incidental Finding and Malignancy Mimickers in Cholecystectomy Specimens: A Retrospective Study

Abstract

Aims: The aim of the study was to evaluate the prevalence of various histopathological spectra in cholecystectomy specimens and to highlight both the histopathological and clinical findings in gallbladder specimens. Study Design: An analytical cross-sectional study. Place and Duration of Study: This study was conducted at the Department of Pathology, Vinayaka Mission Kirupananda Variyar Medical College, Salem, South India, for 2 years (From January 2023 to December 2024). Methodology: This study included 120 formalin-fixed cholecystectomy specimens, excluding autolyzed, inadequate, or poorly preserved samples. It aimed to evaluate the prevalence and spectrum of histopathological lesions—both malignant neoplastic and benign neoplastic—in gallbladder specimens, correlating them with clinical findings, and comparing their incidence across age, gender, and clinical diagnoses. Specimens were selected based on inclusion criteria, with ethical clearance obtained. Results: Among the 120 patients who underwent cholecystectomy, the majority were females (79), with the highest number of cases seen in the 21–40 age group (55 patients). Histopathological examination revealed that 114 cases (95%) were benign neoplastic, while 1 case (4%) was benign neoplasms and 5 cases (1%) were malignant. The most common diagnosis was chronic non-specific cholecystitis (90 cases, 75%). Among malignant neoplastic lesions, papillary adenoma with choledochal cyst was identified in one case. Gallbladder malignancies were observed in five cases (4.17%), with adenocarcinoma being the most common subtype (2 cases). Conclusion: Benign neoplastic lesions, particularly chronic non-specific cholecystitis, were the most common findings in cholecystectomy specimens, with a clear female predominance. Neoplastic lesions were rare, with adenocarcinoma being the most frequent malignancy. The study highlights the importance of routine histopathological examination for early detection of incidental malignancies and accurate diagnosis of rare variants.