Difference between revisions of "Gallbladder adenoma"

From Libre Pathology
Jump to navigation Jump to search
(fix)
 
(10 intermediate revisions by the same user not shown)
Line 1: Line 1:
#redirect [[Gallbladder#Gallbladder_adenoma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =
| Width      =
| Caption    =
| Synonyms  =
| Micro      =
| Subtypes  =
| LMDDx      = [[adenocarcinoma of the gallbladder]], reactive changes - as may be seen in [[acute cholecystitis]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  = [[gallbladder grossing]]
| Staging    =
| Site      = [[gallbladder]]
| Assdx      =
| Syndromes  = [[familial adenomatous polyposis]], [[Peutz-Jeghers syndrome]]
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Gallbladder adenoma''' is a pre-malignant lesion of the [[gallbladder]].
 
''Gallbladder dysplasia'' redirects here.
 
==General==
*Premalignant lesion.
*May be associated with [[familial adenomatous polyposis]] or [[Peutz-Jeghers syndrome]].<ref name=pmid11896229>{{Cite journal  | last1 = Levy | first1 = AD. | last2 = Murakata | first2 = LA. | last3 = Abbott | first3 = RM. | last4 = Rohrmann | first4 = CA. | title = From the archives of the AFIP. Benign tumors and tumorlike lesions of the gallbladder and extrahepatic bile ducts: radiologic-pathologic correlation. Armed Forces Institute of Pathology. | journal = Radiographics | volume = 22 | issue = 2 | pages = 387-413 | month =  | year =  | doi =  | PMID = 11896229 | url = http://radiographics.rsna.org/content/22/2/387.full }}</ref>
 
==Microscopic==
Features:
*Gallbladder epithelium with:
**Nuclear atypia - '''key feature'''.
***Nuclear hyperchromasia.
***Nuclear crowding (pseudostratification) ''or'' round enlarged nuclei.
**+/-Goblet cells.
 
Architectural subclassification:<ref name=pmid22895264>{{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 }}</ref>
*Papillary ~ 45%.
*Tubulopapillary ~ 30%.
*Tubular ~ 25%.
 
Notes:
*Low grade dysplasia should prompt targeted sampling and review.<ref name=uscap2017_akki/>
*Gallbladders with high grade dysplasia should be [[submitted in total]] to exclude [[gallbladder adenocarcinoma]].<ref name=uscap2017_akki>Akki ''et al.'' (2017) "Detecting Incidental Gallbladder Adenocarcinoma: When to Submit the Entire Gallbladder".  Available at: [http://www.abstracts2view.com/uscap17/view.php?nu=USCAP17L_2016 http://www.abstracts2view.com/uscap17/view.php?nu=USCAP17L_2016]. United States and Canadian Academy of Pathology Annual Meeting. Accessed on: April 9, 2017.</ref><ref name=pmid33629395/>
 
DDx:
*[[Gallbladder adenocarcinoma]].
*Reactive changes.
 
===Grading dysplasia===
Low grade dysplasia:<ref name=pmid33629395>{{cite journal |authors=Roa JC, Basturk O, Adsay V |title=Dysplasia and carcinoma of the gallbladder: pathological evaluation, sampling, differential diagnosis and clinical implications |journal=Histopathology |volume=79 |issue=1 |pages=2–19 |date=July 2021 |pmid=33629395 |doi=10.1111/his.14360 |url=}}</ref>
*Surface epithelium changes: hyperchromasia, pseudostratification, elongated nuclei; nuclei stratified/confined mainly to lower aspect of the epithelium.
High grade dysplasia:<ref name=pmid33629395/>
*Diffuse and severe (cytologic) atypia: nuclei no long stratified.
 
===Images===
*[http://radiographics.rsna.org/content/22/2/387/F4.expansion.html Tubular adenoma, biliary type (rsna.org)].<ref name=pmid11896229/>
*[http://www.flickr.com/photos/lunarcaustic/4986649333/ Gallbladder with high-grade dysplasia (flickr.com/lunar caustic)].
 
==Sign out==
<pre>
GALLBLADDER, CHOLECYSTECTOMY:
- BILIARY TYPE TUBULAR ADENOMA WITH HIGH GRADE DYSPLASIA.
- MARGINS CLEAR OF ADENOMA (NEAREST MARGIN 1.0 CM).
</pre>
 
==See also==
*[[Gallbladder]].
*[[Intestinal metaplasia of the gallbladder]].
 
==References==
{{Reflist|1}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Gastrointestinal pathology]]

Latest revision as of 14:50, 15 August 2024

Gallbladder adenoma
Diagnosis in short
LM DDx adenocarcinoma of the gallbladder, reactive changes - as may be seen in acute cholecystitis
Grossing notes gallbladder grossing
Site gallbladder

Syndromes familial adenomatous polyposis, Peutz-Jeghers syndrome

Prevalence uncommon

Gallbladder adenoma is a pre-malignant lesion of the gallbladder.

Gallbladder dysplasia redirects here.

General

Microscopic

Features:

  • Gallbladder epithelium with:
    • Nuclear atypia - key feature.
      • Nuclear hyperchromasia.
      • Nuclear crowding (pseudostratification) or round enlarged nuclei.
    • +/-Goblet cells.

Architectural subclassification:[2]

  • Papillary ~ 45%.
  • Tubulopapillary ~ 30%.
  • Tubular ~ 25%.

Notes:

DDx:

Grading dysplasia

Low grade dysplasia:[4]

  • Surface epithelium changes: hyperchromasia, pseudostratification, elongated nuclei; nuclei stratified/confined mainly to lower aspect of the epithelium.

High grade dysplasia:[4]

  • Diffuse and severe (cytologic) atypia: nuclei no long stratified.

Images

Sign out

GALLBLADDER, CHOLECYSTECTOMY:
- BILIARY TYPE TUBULAR ADENOMA WITH HIGH GRADE DYSPLASIA.
- MARGINS CLEAR OF ADENOMA (NEAREST MARGIN 1.0 CM).

See also

References

  1. 1.0 1.1 Levy, AD.; Murakata, LA.; Abbott, RM.; Rohrmann, CA.. "From the archives of the AFIP. Benign tumors and tumorlike lesions of the gallbladder and extrahepatic bile ducts: radiologic-pathologic correlation. Armed Forces Institute of Pathology.". Radiographics 22 (2): 387-413. PMID 11896229. http://radiographics.rsna.org/content/22/2/387.full.
  2. Adsay, V.; Jang, KT.; Roa, JC.; Dursun, N.; Ohike, N.; Bagci, P.; Basturk, O.; Bandyopadhyay, S. et al. (Sep 2012). "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.". Am J Surg Pathol 36 (9): 1279-301. doi:10.1097/PAS.0b013e318262787c. PMID 22895264.
  3. 3.0 3.1 Akki et al. (2017) "Detecting Incidental Gallbladder Adenocarcinoma: When to Submit the Entire Gallbladder". Available at: http://www.abstracts2view.com/uscap17/view.php?nu=USCAP17L_2016. United States and Canadian Academy of Pathology Annual Meeting. Accessed on: April 9, 2017.
  4. 4.0 4.1 4.2 Roa JC, Basturk O, Adsay V (July 2021). "Dysplasia and carcinoma of the gallbladder: pathological evaluation, sampling, differential diagnosis and clinical implications". Histopathology 79 (1): 2–19. doi:10.1111/his.14360. PMID 33629395.