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Difference between revisions of "Gallbladder"
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==Cholelithiasis== | ==Cholelithiasis== | ||
*[[AKA]] ''gallstones''. | *[[AKA]] ''gallstones''. | ||
{{Main|Cholelithiasis}} | |||
=Less common pathologic diagnoses= | =Less common pathologic diagnoses= | ||
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*Abbreviated ''XGC''. | *Abbreviated ''XGC''. | ||
{{Main|Xanthogranulomatous cholecystitis}} | {{Main|Xanthogranulomatous cholecystitis}} | ||
==Pancreatic heterotopia== | |||
[[File:Gallbladder mass benign A sl 1.png|Pancreatic heterotopia in 35 year old women]] | |||
[[File:Gallbladder mass benign A sl 2.png|Pancreatic heterotopia in 35 year old women]] | |||
[[File:Gallbladder mass benign A sl 3.png|Pancreatic heterotopia in 35 year old women]] | |||
[[File:Gallbladder mass benign A sl 4.png|Pancreatic heterotopia in 35 year old women]]<br> | |||
Pancreatic heterotopia near cystic duct in 35 year old women. A. The cystic duct margin is at right; the heterotopia, at left. This cannot be a portion of the pancreas because the cystic duct margin lies proximal to the common bile duct. B. Pancreatic ducts with lobular proliferation, but without the inflammation that would usually be present were this obstruction by a gallstone. C. Nuclei of the duct and the proliferated bile ductules are bland. D. Acini are unremarkable; no pancreatic islets were seen in this case. | |||
=Premalignant lesions= | =Premalignant lesions= | ||
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Images: | Images: | ||
*[http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282005%29129%3C386%3APPOGDA%3E2.0.CO%3B2 Gallbladder metaplasias (archivesofpathology.org)].<ref name=pmid15737036>{{cite journal |author=Mukhopadhyay S, Landas SK |title=Putative precursors of gallbladder dysplasia: a review of 400 routinely resected specimens |journal=Arch. Pathol. Lab. Med. |volume=129 |issue=3 |pages=386–90 |year=2005 |month=March |pmid=15737036 |doi= |url=http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282005%29129%3C386%3APPOGDA%3E2.0.CO%3B2 }}</ref> | *[http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282005%29129%3C386%3APPOGDA%3E2.0.CO%3B2 Gallbladder metaplasias (archivesofpathology.org)].<ref name=pmid15737036>{{cite journal |author=Mukhopadhyay S, Landas SK |title=Putative precursors of gallbladder dysplasia: a review of 400 routinely resected specimens |journal=Arch. Pathol. Lab. Med. |volume=129 |issue=3 |pages=386–90 |year=2005 |month=March |pmid=15737036 |doi= |url=http://www.archivesofpathology.org/doi/pdf/10.1043/1543-2165%282005%29129%3C386%3APPOGDA%3E2.0.CO%3B2 }}</ref> | ||
===Sign out=== | ===Sign out=== | ||
<pre> | <pre> | ||
Gallbladder, Cholecystectomy: | |||
- | - Chronic cholecystitis with antral-type metaplasia, NEGATIVE for dysplasia. | ||
- | - Cholelithiasis. | ||
</pre> | </pre> | ||
==Gallbladder adenoma== | |||
:''Gallbladder dysplasia'' is covered in ''[[gallbladder adenoma]]''. | |||
{{Main|Gallbladder adenoma}} | |||
==Intracholecystic Papillary Neoplasm<ref>{{Cite journal | last1 = Adsay | first1 = V. | last2 = Jang | first2 = KT. | last3 = Roa | first3 = JC. | last4 = Dursun | first4 = N. | last5 = Ohike | first5 = N. | last6 = Bagci | first6 = P. | last7 = Basturk | first7 = O. | last8 = Bandyopadhyay | first8 = S. | last9 = Cheng | first9 = JD. | title = Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are ≥1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases. | journal = Am J Surg Pathol | volume = 36 | issue = 9 | pages = 1279-301 | month = Sep | year = 2012 | doi = 10.1097/PAS.0b013e318262787c | PMID = 22895264 }} | ==Intracholecystic Papillary Neoplasm<ref>{{Cite journal | last1 = Adsay | first1 = V. | last2 = Jang | first2 = KT. | last3 = Roa | first3 = JC. | last4 = Dursun | first4 = N. | last5 = Ohike | first5 = N. | last6 = Bagci | first6 = P. | last7 = Basturk | first7 = O. | last8 = Bandyopadhyay | first8 = S. | last9 = Cheng | first9 = JD. | title = Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are ≥1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases. | journal = Am J Surg Pathol | volume = 36 | issue = 9 | pages = 1279-301 | month = Sep | year = 2012 | doi = 10.1097/PAS.0b013e318262787c | PMID = 22895264 }} | ||
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*Oten arise in a background of pyloric-gland metaplasia. | *Oten arise in a background of pyloric-gland metaplasia. | ||
*May be associated with invasive adenocarcinoma, which should be reported as intracystic papillary neoplasm with an associated invasive carcinoma and staged. | *May be associated with invasive adenocarcinoma, which should be reported as intracystic papillary neoplasm with an associated invasive carcinoma and staged. | ||
*Population | |||
**Female (F/M=2:1) | |||
**Mean age 61 | |||
*Presentations | |||
**Pain | |||
**Incidental | |||
*No particular association with gallstones. | |||
===Microscopic=== | ===Microscopic=== | ||
*Cell types | *Cell types | ||
**Pancreatobiliary type | **Pancreatobiliary type | ||
**Intestinal | **Intestinal types with goblet, Paneth, and/or serotonin-containing cells. | ||
*Architecture | *Architecture | ||
**Papillary | **Papillary | ||
**Tubulopapillary | **Tubulopapillary | ||
**Tubular | **Tubular | ||
*Dysplasia - high or low grade | |||
<gallery> | |||
Image:GallBladder IntracysticPapillaryNeoplasm WA InvasiveAdenocarcinoma LP CTR.jpg|Gall Bladder - Intracholecystic Papillary Neoplasm with Invasive Adenocarcinoma - Low power (SKB) | |||
Image:GallBladder IntracysticPapillaryNeoplasm WA InvasiveAdenocarcinoma HP CTR.jpg|Gall Bladder - Intracholecystic Papillary Neoplasm with Invasive Adenocarcinoma - High power (SKB) | |||
Image:GallBladder IntracysticPapillaryNeoplasm WA InvasiveAdenocarcinoma HP3 CTR.jpg|Gall Bladder - Intracholecystic Papillary Neoplasm with Invasive Adenocarcinoma - High power (SKB) | |||
Image:GallBladder IntracysticPapillaryNeoplasm WA InvasiveAdenocarcinoma HP2 CTR.jpg|Gall Bladder - Intracholecystic Papillary Neoplasm with Invasive Adenocarcinoma - High power (SKB) | |||
Image:GallBladder IntracysticPapillaryNeoplasm WA InvasiveAdenocarcinoma MP CTR.jpg|Gall Bladder - - Intracholecystic Papillary Neoplasm with Invasive Adenocarcinoma - Malignant gland infiltrating stroma - High power (SKB) | |||
Image:GallBladder IntracysticPapillaryNeoplasm WA InvasiveAdenocarcinoma HP4 CTR.jpg|Gall Bladder - Intracholecystic Papillary Neoplasm with Invasive Adenocarcinoma - - Malignant gland infiltrating stroma - Very high power (SKB) | |||
Image:Gallbladder IntracysticPapillaryNeoplasm HighGradeDysplasia LP PA.JPG|Gall Bladder - Intracholecystic Papillary Neoplasm with high grade dysplasia - Low power (SKB) | |||
Image:Gallbladder IntracysticPapillaryNeoplasm HighGradeDysplasia MP PA.JPG|Gall Bladder - Intracholecystic Papillary Neoplasm with high grade dysplasia - Medium power (SKB) | |||
</gallery> | |||
Notes: | |||
All of the gallbladder should be submitted prior to sign out to exclude invasive adenocarcinoma. | |||
=Malignant= | =Malignant= | ||