Aspiration cytology of the gallbladder

Relationship between cytologic findings and histologic features

Abstract

To study the relation of cytologic findings to histologic features in gallbladder diseases, aspiration cytology of the gallbladder using its contents aspirated during surgery and histologic examination of the resected gallbladder were performed in 101 cases with cholelithiasis. On cytologic examination, evidence of epithelial cells, inflammatory cells (leukocytes, lymphocytes and histiocytes) and debris were investigated. The resected gallbladder were histologically classified into normal, mild cholecystitis, lymph-follicular cholecystitis, acute obstructive cholecystitis, chronic obstructive cholecystitis and cancer.
The relation observed between cytology and histology follows; Only scattered clusters of epithelial cells were seen in normal cases, and epithelial cells, a few inflammatory cells and debris in mild cholecystitis. In lymphfollicular cholecystitis, the smears showed lymphocytes-the aggregates of which were occasionally diagnostic-added to epithelial cells and debris. Numerous inflammatory cells, especially leukocytes and histiocytes, debris and single epithelial cells were exfoliated on the dirty smears in acute obstructive cholecystitis. A few clusters of epithelial cells, debris and a few multi-nucleated giant cells were found in chronic obstructive obstructive cholecystitis. Only one of four cancer cases revealed cancer cells.
In conclusion, the relationship between cytology and histology of the gallbladder with moderate or high inflammation is present, but no sufficiently accurate cell collection is obtained to make a cytologic diagnosis possible through aspiration in normal and cancer cases. It would be a problem to be resolved in future to achieve such accurate cell collection through aspiration.