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Difference between revisions of "Gallbladder carcinoma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Gallbladder adenocarcinoma (2) histopathology.jpg | |||
| Width = | |||
| Caption = Gallbladder adenocarcinoma. [[H&E stain]]. | |||
| Micro = atypical epithelium usually gland forming, may be bland with an infiltrative growth pattern | |||
| Subtypes = | |||
| LMDDx = [[adenomyoma of the gallbladder]], [[metastasis|metastatic carcinoma]] (e.g. [[cholangiocarcinoma]]), [[gallbladder adenoma]] | |||
| Stains = | |||
| IHC = CK7 +ve, CK20 -ve, CDX2 -ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = lesion - usually fundus of gallbladder | |||
| Grossing = [[gallbladder grossing]] | |||
| Site = [[gallbladder]] | |||
| Assdx = [[chronic cholecystitis]], [[gallstones]], [[primary sclerosing cholangitis]], [[intestinal metaplasia of the gallbladder]] | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
}} | |||
'''Gallbladder carcinoma''' is a malignant epithelial neoplasm arising from the [[gallbladder]]. Most gallbladder carcinomas are [[adenocarcinoma]]s. | '''Gallbladder carcinoma''' is a malignant epithelial neoplasm arising from the [[gallbladder]]. Most gallbladder carcinomas are [[adenocarcinoma]]s. | ||
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Image: | Image: | ||
*[http://www.flickr.com/photos/santoshpath/5245332515/ Papillary gallbladder adenocarcinoma (flickr.com)]. | *[http://www.flickr.com/photos/santoshpath/5245332515/ Papillary gallbladder adenocarcinoma (flickr.com)]. | ||
==Microscopic== | |||
Features: | Features: | ||
*Usually adenocarcinoma. | *Usually adenocarcinoma. | ||
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Notes: | Notes: | ||
*May be very subtle, i.e. difficult to differentiate from normal glands. | *May be very subtle, i.e. difficult to differentiate from normal glands. | ||
**"Deep glands" that look bland shouldn't immediately be dismissed as benign. | |||
Subtypes: | |||
*[[Mucinous carcinoma]].<ref name=pmid23106580/> | |||
DDx: | DDx: | ||
*[[Adenomyoma of the gallbladder]]. | *[[Adenomyoma of the gallbladder]]. | ||
*[[Gallbladder adenoma]]. | |||
*[[metastasis|Metastatic carcinoma]]. | *[[metastasis|Metastatic carcinoma]]. | ||
**[[Cholangiocarcinoma]]. | **[[Cholangiocarcinoma]]. | ||
*[[Chronic cholecystitis]] with glands extending deep into the wall. | |||
===Images=== | ===Images=== | ||
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Image:Gallbladder adenocarcinoma (3) lymphatic invasion histopathology.jpg | GB carcinoma - LVI. (WC) | Image:Gallbladder adenocarcinoma (3) lymphatic invasion histopathology.jpg | GB carcinoma - LVI. (WC) | ||
</gallery> | </gallery> | ||
www: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285085/figure/F1/ Mimics of GB carcinoma (nih.gov)].<ref name=pmid22284391>{{Cite journal | last1 = Giang | first1 = TH. | last2 = Ngoc | first2 = TT. | last3 = Hassell | first3 = LA. | title = Carcinoma involving the gallbladder: a retrospective review of 23 cases - pitfalls in diagnosis of gallbladder carcinoma. | journal = Diagn Pathol | volume = 7 | issue = | pages = 10 | month = | year = 2012 | doi = 10.1186/1746-1596-7-10 | PMID = 22284391 }}</ref> | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285085/figure/F2/ Dysplasia in RA sinuses (nih.gov)]. | |||
[[File:5 42027008799505 sl 1.png| Moderately differentiated adenocarcinoma of gallbladder]] | |||
[[File:5 42027008799505 sl 2.png| Moderately differentiated adenocarcinoma of gallbladder]] | |||
[[File:5 42027008799505 sl 3.png| Moderately differentiated adenocarcinoma of gallbladder]] | |||
[[File:5 42027008799505 sl 4.png| Moderately differentiated adenocarcinoma of gallbladder]] | |||
[[File:5 42027008799505 sl 5.png| Moderately differentiated adenocarcinoma of gallbladder]] | |||
[[File:5 42027008799505 sl 6.png| Moderately differentiated adenocarcinoma of gallbladder]]<br> | |||
Moderately differentiated adenocarcinoma of gallbladder in a 59 year old man. A. Tumor bounds cystic duct. B. Cystic duct at left shows high grade dysplasia. At right lie acini and nests of round and sometimes spindled cancerous nuclei. Overall most of the tumor was in tubules/acini, meaning the lesion is moderately differentiated. C. Region with Rokitansky-Aschoff sinuses showing high grade dysplasia and foci of intestinal metaplasia, with some nests likely being invasive cancer. D. Tumorous involvement of cystic duct lymph node. E. Bizarrely shaped cancerous groups. F. invasion of liver by neoplastic acini. | |||
==IHC== | |||
Features - conventional:<ref name=pmid23106580>{{Cite journal | last1 = Dursun | first1 = N. | last2 = Escalona | first2 = OT. | last3 = Roa | first3 = JC. | last4 = Basturk | first4 = O. | last5 = Bagci | first5 = P. | last6 = Cakir | first6 = A. | last7 = Cheng | first7 = J. | last8 = Sarmiento | first8 = J. | last9 = Losada | first9 = H. | title = Mucinous carcinomas of the gallbladder: clinicopathologic analysis of 15 cases identified in 606 carcinomas. | journal = Arch Pathol Lab Med | volume = 136 | issue = 11 | pages = 1347-58 | month = Nov | year = 2012 | doi = 10.5858/arpa.2011-0447-OA | PMID = 23106580 }}</ref> | |||
*CK7 +ve (7 of 8 cases). | |||
*CK20 -ve (7 of 8 cases). | |||
*CDX2 -ve (8 of 8 cases). | |||
==See also== | ==See also== | ||