Intestinal Nature in Gallbladder Carcinoma with Reference to its Histogenesis
Forty advanced cases of gallbladder carcinoma were examined by the use of histochemical and immunohistological methods, in which attention was focused on intestinal metaplasia seen in and around the lesions. Twenty-nine percent for cases of well-differentiated adenocarcinoma displayed goblet cell-type carcinoma cells within the lesions, while no similar cell was evident in cases of poorly differentiated adenocarcinoma. Ten percent for cases of gallbladder carcinoma included endocrine cells within neoplastic tissues, all of which consisted of well-differentiated adenocarcinoma and mucosal areas adjacent to which also contained similar cells. Mucosal areas in the proximity to foci of well-differentiated adenocarcinoma demonstrated a marked increase in the amount of non-sulfated acid mucin, but no such tendency was discernible around foci of poorly differentiated adenocarcinoma. Lysozyme immunoreactivity was identifiable in a high percent of well-differentiated adenocarcinoma foci and their surrounding mucosal areas, while similar reactivity was rarely present in cases of poorly differentiated adenocarcinoma. It may be suggested from these results that an intimate relationship would exist in between intestinal metaplasia and well-differentiated adenocarcinoma occurring in the gallbladder. It is, however, to be determined whether or not intestinal metaplasia alone would act as a precancerous lesion like adenoma, dysplasia and possibly hyperplastic polyp for the histogenesis of gallbladder carcinomas.