Difference between revisions of "Gallbladder"

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Gallbladder (view source)

Revision as of 02:32, 17 December 2013

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→‎Gallbladder carcinoma: split out
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=Malignant=
=Malignant=
==Gallbladder carcinoma==
==Gallbladder carcinoma==
*[[AKA]] ''gallbladder adenocarcinoma''.
{{Main|Gallbladder carcinoma}}
===General===
*Uncommon.
 
Treatment:
*Cholecystectomy +/- lymph nodes +/- partial hepatectomy.<ref name=pmid20639849>{{Cite journal  | last1 = Biswas | first1 = PK. | title = Carcinoma gallbladder. | journal = Mymensingh Med J | volume = 19 | issue = 3 | pages = 477-81 | month = Jul | year = 2010 | doi =  | PMID = 20639849 }}</ref>
 
====Epidemiology====
*Associated with gallstones.
*Increased risk in [[primary sclerosing cholangitis]].
*Sex: female > male.
*Location: usually fundus, sometimes body.
 
Notes:
*Diffuse calcification of gallbladder wall, [[AKA]] "porcelain gallbladder" is '''not''' associated with carcinoma - based on a series of 10,741 cholecystectomies.<ref name=pmid11206901>{{cite journal |author=Towfigh S, McFadden DW, Cortina GR, ''et al'' |title=Porcelain gallbladder is not associated with gallbladder carcinoma |journal=Am Surg |volume=67 |issue=1 |pages=7?0 |year=2001 |month=January |pmid=11206901 |doi= |url=}}</ref>
**Focal mucosal calcification ''is'' associated with malignancy.<ref name=pmid11391368>{{Cite journal  | last1 = Stephen | first1 = AE. | last2 = Berger | first2 = DL. | title = Carcinoma in the porcelain gallbladder: a relationship revisited. | journal = Surgery | volume = 129 | issue = 6 | pages = 699-703 | month = Jun | year = 2001 | doi = 10.1067/msy.2001.113888 | PMID = 11391368 }}</ref>
*[[Cholangiocarcinoma]] is dealt with in the ''[[liver neoplasms]]'' article.
 
===Gross===
*Classic: mass projecting into the lumen.
*Marked gallbladder wall thickening.
**>10 mm should be considered with suspicion.<ref name=pmid21879282>{{Cite journal  | last1 = Kim | first1 = HJ. | last2 = Park | first2 = JH. | last3 = Park | first3 = DI. | last4 = Cho | first4 = YK. | last5 = Sohn | first5 = CI. | last6 = Jeon | first6 = WK. | last7 = Kim | first7 = BI. | last8 = Choi | first8 = SH. | title = Clinical usefulness of endoscopic ultrasonography in the differential diagnosis of gallbladder wall thickening. | journal = Dig Dis Sci | volume = 57 | issue = 2 | pages = 508-15 | month = Feb | year = 2012 | doi = 10.1007/s10620-011-1870-0 | PMID = 21879282 }}</ref>
 
Image:
*[http://www.flickr.com/photos/santoshpath/5245332515/ Papillary gallbladder adenocarcinoma (flickr.com)].
===Microscopic===
Features:
*Usually adenocarcinoma.
**Mimics appearance of [[pancreatic ductal adenocarcinoma]] -- but less cellular mucin.<ref name=Ref_DCHH174>{{Ref DCHH|174}}</ref>
 
Notes:
*May be very subtle, i.e. difficult to differentiate from normal glands.
 
DDx:
*[[Adenomyoma of the gallbladder]].
*[[metastasis|Metastatic carcinoma]].
**[[Cholangiocarcinoma]].
 
====Images====
<gallery>
Image:Gallbladder_adenocarcinoma_(1)_histopathology.jpg | GB carcinoma - low mag. (WC)
Image:Gallbladder adenocarcinoma (2) histopathology.jpg | GB carcinoma - high mag. (WC)
Image:Gallbladder adenocarcinoma (3) lymphatic invasion histopathology.jpg | GB carcinoma - LVI. (WC)
</gallery>


=See also=
=See also=
Michael
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