Difference between revisions of "Gallbladder"

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==Gallbladder adenoma==
==Gallbladder adenoma==
:''Gallbladder dysplasia'' redirects here.
{{Main|Gallbladder adenoma}}
===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>
 
DDx:
*[[Gallbladder adenocarcinoma]].
*Reactive changes.
 
====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>


==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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