Difference between revisions of "Gallbladder adenoma"

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#redirect [[Gallbladder#Gallbladder_adenoma]]
'''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>
 
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>
 
==See also==
*[[Gallbladder]].
 
==References==
{{Reflist|1}}


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

Revision as of 14:05, 30 October 2017

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:

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.