Gallbladder ICPN : Low-grade Dysplasia

Comments:
Dysplasia in Intracholecystic Papillary-Tubular Neoplasms (ICPNs) can range from low-grade to high-grade. In low-grade dysplasia (shown here), the architectural and cytologic changes are subtle. The nuclei are hyperchromatic and may be slightly enlarged but still uniform in shape. The nuclei maintain polarity and are mostly confined to the lower aspect of the epithelium. Nucleoli are inconspicuous or small.

High-grade dysplasia is more likely to occur in lesions > 1 cm in size. There is architectural complexity with nuclear enlargement and hyperchromasia, pleomorphism, pseudostratification with loss of polarity, and mucin depletion. Mitotic activity is increased. One may see transition from low-grade to high-grade dysplasia. High-grade dysplasia often extends into adjacent flat mucosa.