Gallbladder adenoma
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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.[1]
Microscopic
Features:
- Gallbladder epithelium with:
- Nuclear atypia - key feature.
- Nuclear hyperchromasia.
- Nuclear crowding (pseudostratification) or round enlarged nuclei.
- +/-Goblet cells.
- Nuclear atypia - key feature.
Architectural subclassification:[2]
- Papillary ~ 45%.
- Tubulopapillary ~ 30%.
- Tubular ~ 25%.
Notes:
- Low grade dysplasia should prompt targeted sampling and review.[3]
- Gallbladders with high grade dysplasia should be submitted in total to exclude gallbladder adenocarcinoma.[3][4]
DDx:
- Gallbladder adenocarcinoma.
- Reactive changes.
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
- Tubular adenoma, biliary type (rsna.org).[1]
- Gallbladder with high-grade dysplasia (flickr.com/lunar caustic).
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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
- ↑ 1.0 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.
- ↑ 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.
- ↑ 3.0 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.
- ↑ 4.0 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.