Correlation of Biliary Intraepithelial Neoplasia with Clinico-Radiological and Histomorphological Characteristics: A Cross-Sectional Study

Background: Biliary intraepithelial neoplasia (BilIN) is an important precursor lesion associated with gallbladder carcinogenesis. Chronic inflammatory changes and prolonged mucosal irritation caused by gallbladder pathology contribute significantly to epithelial instability and dysplastic transformation. Early identification of clinicoradiological alterations associated with BilIN is essential for understanding disease progression and identifying patients at increased risk for advanced dysplasia. The aim is to correlate biliary intraepithelial neoplasia with clinico-radiological and histomorphological characteristics. Material and Methods: This cross-sectional study was conducted in the Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, over a period of one year from April 2024 to March 2025. A total of 170 histopathologically diagnosed cases of biliary intraepithelial neoplasia identified in cholecystectomy specimens were included in the study. Clinical details, symptom duration, and radiological characteristics including gallbladder distension and wall thickness were evaluated. Histopathological diagnosis was established using hematoxylin and eosin stained sections. Statistical analysis was performed using SPSS software and p-value less than 0.05 was considered statistically significant. Results: Female patients predominated with 136 cases (80.00%), whereas male patients constituted 34 cases (20.00%). The majority of patients presented with symptoms persisting for 3–6 months accounting for 58.24% of cases. Significant association was observed between gallbladder distension and BilIN grade (p=0.0261). Distended gallbladder demonstrated predominance of low-grade BilIN lesions, whereas normal gallbladder morphology showed comparatively higher proportion of high-grade BilIN lesions. Thin gallbladder wall was observed in 75.00% cases, whereas thickened wall was identified in 25.00% cases. Conclusion: Biliary intraepithelial neoplasia demonstrates significant association with chronic clinicoradiological gallbladder alterations including prolonged symptom duration, altered gallbladder distension, and wall thickness changes. These findings support the role of chronic inflammatory gallbladder pathology in dysplastic epithelial transformation.

Keywords: Biliary intraepithelial neoplasia, Gallbladder, Dysplasia, Cholelithiasis, Gallbladder wall thickness.