W. Kimura et al., INCIDENCE AND PATHOGENESIS OF VILLOUS TUMORS OF THE GALLBLADDER, AND THEIR RELATION TO CANCER, Journal of gastroenterology, 29(1), 1994, pp. 61-65
The aim of this study was to investigate the incidence and pathogenesi
s of villous tumors of the gallbladder, and their relation to cancer.
Five hundred and thirty-three cases of cholecystectomy and 1300 random
ly selected autopsy cases, mainly elderly individuals, were investigat
ed. Gallbladders were fixed in 10% formalin after operation or at auto
psy, followed by macroscopic study. In cases of villous tumors, the en
tire gallbladder was cut into 5-mm-thick serial sections, embedded in
paraffin, cut to 4-mum, stained with hematoxylin and eosin (H&E), and
histologically studied. To investigate cancer-associated antigens, i.e
., carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9,
deparaffinized sections were examined by the peroxidase-antiperoxidase
(PAP) immunohistochemical technique with anti-CEA and anti-CA 19-9 an
tibodies. Villous tumor was found in two resected cases (0.38%) and in
one autopsy case (0.08%). Histologically, one of the villous tumors c
onsisted mainly of a proliferation of lining epithelia; the other two
consisted mainly of a proliferation of glands. In all three cases, the
patients had had accompanying chronic or acute inflammation and two w
ere accompanied by cholecystolithiasis, which made us aware of the imp
ortance of inflammation or trauma from stones in the pathogenesis of s
uch neoplasms. Although no apparent cancerous epithelium was observed
in any of these tumors by studying H&E specimens, moderate structural
and cellular atypism was found in one of them. The atypical epithelium
in this case was positively stained for CEA and CA 19-9. It was concl
uded that villous tumor should be considered to be a premalignant lesi
on.