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Among epithelial alterations, pseudo\u2010pyloric gland metaplasia is ubiquitous and of no apparent consequence, whereas goblet cell metaplasia and a foveolar change in surface cells require closer attention. Low\u2010grade dysplasia is difficult to objectively define and appears to be clinically inconsequential by itself; however, extra sampling is required to exclude the possibility of accompanying more significant lesions. For high\u2010grade dysplasia (\u2018high\u2010grade BilIN\u2019, also known as \u2018carcinoma <jats:italic>in situ<\/jats:italic>\u2019), a complete sampling is necessary to rule out invasion. Designating <jats:italic>in\u2010situ<\/jats:italic> or minimally invasive carcinomas limited to muscularis or above as early gallbladder carcinoma (EGBC) helps to alleviate the major geographical differences (West\/East) in the criteria for \u2018invasiveness\u2019 to assign a case to pTis or pT1. Total sampling is crucial in proper diagnosis of such cases. A subset of invasive GBCs (5\u201310%) arise from the intracholecystic neoplasm (ICN, \u2018adenoma\u2010carcinoma sequence\u2019) category. Approximately two\u2010thirds of ICNs have invasive carcinoma. However, this propensity differs by subtype. True \u2018pyloric gland adenomas\u2019 (&gt;\u00a01\u00a0cm) are uncommon and scarcely associated with invasive carcinoma. A distinct subtype of ICN composed of tubular, non\u2010mucinous MUC6<jats:sup>+<\/jats:sup> glands [intracholecystic tubular non\u2010mucinous neoplasm (ICTN)] forms a localised pedunculated polyp. Although it is morphologically complex and high\u2010grade, it appears to be invasion\u2010resistant. Some of the invasive carcinoma types in the gallbladder have been better characterised recently with adenosquamous, neuroendocrine, poorly cohesive and mucinous carcinomas often being more advanced and aggressive.<\/jats:p>","DOI":"10.1111\/his.14360","type":"journal-article","created":{"date-parts":[[2021,2,25]],"date-time":"2021-02-25T08:11:16Z","timestamp":1614240676000},"page":"2-19","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Dysplasia and carcinoma of the gallbladder: pathological evaluation, sampling, differential diagnosis and clinical implications"],"prefix":"10.1111","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-8774","authenticated-orcid":false,"given":"Juan C","family":"Roa","sequence":"first","affiliation":[{"name":"Department of Pathology School of Medicine Pontificia Universidad Catolica de Chile Santiago Chile"},{"name":"European\u2013Latin American ESCALON Consortium EU Horizon 2020 Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2747-1366","authenticated-orcid":false,"given":"Olca","family":"Basturk","sequence":"additional","affiliation":[{"name":"Department of Pathology Memorial Sloan Kettering Cancer Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1308-3701","authenticated-orcid":false,"given":"Volkan","family":"Adsay","sequence":"additional","affiliation":[{"name":"Department of Pathology Ko\u00e7 University Hospital and Ko\u00e7 University Research Center for Translational Medicine (KUTTAM) Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,5,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.25421"},{"key":"e_1_2_8_3_1","first-page":"283","volume-title":"Digestive system tumours. 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