Gallbladder grossing
This article covers gallbladder grossing, also cholecystectomy specimens.
Introduction
These specimens are very common and could be classified as a ditzel.
Cholecystectomies are usually done for chronic cholecystitis (increasingly common in western countries due to the increasing prevalence of obesity). Less common indications are acute cholecystitis and gallstones (may cause gallstone pancreatitis, Mirizzi syndrome[1]).
Specimen opening
These are not routinely opened before cut-up.
Protocol
- Specimen: Gallbladder.
- Received: [intact/opened/open with defect measuring ___ cm].
Dimensions:
- External dimensions: ___ cm length, ___ cm diameter.
- Wall thickness (maximal): ___ cm.
Appearance:
- Serosal surface: [tan and smooth/rough].
- Lumen contains: [thick green bile/multiple [yellow/green/black] calculi].
- Mucosa: [dark green and velvety/granular, hemorrhagic/strawberry-like].
- Polyp/tumour: [not identified/___ cm in maximal dimension].
- Wall: [pliable/firm].
- Neck: [pliable/firm].
- Cystic duct: [patent/not patent].
- Cystic duct lymph node: [not identified/present, measuring ___ cm in greatest dimension].
Sections:
- Representive sections of the neck, body and fundus, including the cystic duct lymph node, are submitted in one cassette.
Protocol notes
- High-grade dysplasia should prompt submitting the gallbladder in total, if cancer is not present.[2]
- Intestinal metaplasia of the gallbladder does not have to be submitted in total.[2]
Staging
Alternate approaches
See also
Related protocols
References
- ↑ Hsu, YB.; Yu, SC.; Lee, PH.; Wei, TC. (Apr 1994). "An uncommon cause of biliary obstruction (Mirizzi syndrome): report of five cases.". J Formos Med Assoc 93 (4): 314-9. PMID 7914773.
- ↑ 2.0 2.1 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.