Abstract : Introduction: Gall bladder lesions include the varied spectrum of lesions encompassing inflammatory,
benign, premalignant and malignant conditions. Progression from benign to malignant change is a
complex process. The pathological importance of chronic inflammation leading to neoplasia has come
into prominence in recent years. Multiple mechanisms are involved in the carcinogenesis and the most
commonly disrupted gene is the p53 gene.
Materials and Methods: In our prospective study, of three consecutive years duration a total of 262
specimens which included inflammatory, premalignant, and malignant lesions of the gall bladder were
received. Immunohistochemical analysis with a p53 antibody was done on selected 60 specimens according
to our inclusion criteria.
Results: Of the received specimens majority (84.7%) were inflammatory lesions followed by precursor
lesions (10.7%) and malignant lesions (4.5%). Chronic cholecystitis with cholelithiasis is the predominant
lesion accounting for 33% of the cases. P53 expression was observed in 50% of malignancies and was not
seen in any of the premalignant conditions. 11.8% of inflammatory lesions with thickened wall showed p53
Conclusion: The most common histopathological diagnosis was chronic cholecystitis. Chronic
inflammation is a major risk factor for malignancy. Careful pathological examination of gallbladder
specimens should be done as the neoplastic process may present silently as cholecystitis. P53 expression
in chronic inflammatory conditions indicates an important role of inflammation in chronic cholecystitiscarcinoma
sequence. Early detection of p53 mutation by Immunohistochemical analysis, and regular follow
up aid in optimal patient management.
Keywords: Gall bladder, Cholecystitis, p53.