Kisisel gözlemimiz ve literatürden derlenmis bilgiler isiginda tam netlesmemis bir klinik antite olarak kolesterolozis
Cholesterolosis as a clinical entity which has not been clarified completely by review of the literature and our experience
- Ana Sayfa
- Sayılar
- Kisisel gözlemimiz ve literatürden derlenmis bilgiler isiginda tam netlesmemis bir klinik antite olarak kolesterolozis...
SB Yüksek Ihtisas Hastanesi, Gastroenteroloji Bölümü3, Ankara
Özet
Giris ve amaç: Etyolojisi net olarak aydinlatilamamakla birlikte histopatolojik açidan kolayca teshis edilerek daha ziyade histomorfolojik bir antite olarak yaklasilan safra kesesi kolesterolozisinin klinik açidan da sorgulanmaya baslandigi görülmekte, semptomlara neden olabilecegi bildirilmektedir. Kolesterolozise kolesistektomi spesmenlerinin %10- 25’inde rastlandigi belirtilmektedir. Gereç ve yöntem: SSK Gazi Hastanesi (TCDD Ankara Hastanesi) Patoloji departmanina gönderilen ve 1995-2004 yillari arasinda klinikoultrasonografik olarak kolelityazis ve/veya kronik kolesistit tanisiyla opere edilen 118 olgunun kolesistektomi spesmenlerindeki histopatolojik özellikler ve tani raporlari kolesterolozis varligi yönünden incelenmistir. Bulgular: 118 olgudan 21’inde (% 11,6) kolesterolozis varligi saptanmistir. Kolesterolozisli olgularin hepsi kadin hasta olup yaslari 37-75 arasinda degismektedir. Ortalama yas 56,4’tür (median: 60). 11 olguda (% 5,8) kolesterolozis ve kronik tasli kolesistit; 8 olguda (% 4,3) kolesterolozis ve kolelityazis birlikteligi gözlenmis, ilginç olarak 2 olguda (% 1,5) ise histopatolojik olarak yalni z kolesterolozis tanisi verildigi dikkati çekmistir. Sonuç: Literatürde de kolesterolozisin nadiren klinik semptomlara neden olabilecegi, kolesistografik ve ultrasonografik olarak anomali tespit edilemeyen biliyer sistem rahatsizligi düsünülen hastalarda kolesterolozis olasiliginin düsünülmesi gerektigi vurgulanmaktadir. Kolesterolozis saptanmasi durumunda, gözlenen semptomlara göre klinik takip veya konservatif destek tedavisi gerekliligi, biliyer kolik episodlarinin gözlendigi pür kolesterolozis olgularinda ise kolesistektomi uygulanabilecegi belirtilmektedir.
Abstract
Background/aim: Cholesterolosis of the human gallbladder has long been considered as a histomorphological entity. Although its etiology has not been fully understood, recognition of cholesterolosis by the pathologist is easy. Recently it has been questioned whether it is a clinical as well as a histomorphological entity, and it has been reported that it could cause symptoms. Materials and methods: In the Pathology Department of SSK Gazi Hospital, we examined 118 cholecystectomy specimens of patients who were operated because of chronic cholecystitis and/or cholelithiasis and reviewed the histopathologic diagnoses regarding the existence of cholesterolosis. Results: We found cholesterolosis in 21 cases (11.6%) of 118 cholecystectomy specimens. All cases were female and ages ranged between 37 and 75 (median: 60). Eleven cases (5.8%) had cholesterolosis with chronic calculous cholecystitis and 8 cases (4.3%) had cholesterolosis with cholelithiasis. Remarkably, we found 2 cases (1.5%) in whose specimens cholesterolosis was the only histopathological finding. Conclusion: In the literature it has also been emphasized that cholesterolosis might cause clinical symptoms and that it should be suspected in patients with symptoms suggestive of biliary disease and with no abnormality on cholecystography or ultrasonography. When cholesterolosis is detected, an appropriate curative approach (clinical following symptomatic supportive treatment, and even cholecystectomy in patients with biliary colic episodes) would prevent the patient’s suffering from being symptomatic.
