Difference between revisions of "Gallbladder adenoma"

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{{ 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 adenoma''' is a pre-malignant lesion of the [[gallbladder]].


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Notes:
Notes:
*Low grade dysplasia should prompt targeted sampling and review.<ref name=uscap2017_akki/>
*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>
*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/>
 
Grading:<ref name=pmid33629395>{{cite journal |vauthors=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>
*Low-grade.
*High-grade.


DDx:
DDx:
*[[Gallbladder adenocarcinoma]].
*[[Gallbladder adenocarcinoma]].
*Reactive changes.
*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===
===Images===

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

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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.