Difference between revisions of "Gallbladder grossing"
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These specimens are very common and could be classified as a [[ditzel]]. | These specimens are very common and could be classified as a [[ditzel]]. | ||
Cholecystectomies are usually done for [[chronic cholecystitis]] (increasingly common due to prevalence of [[obesity]]). Less common indications are [[acute cholecystitis]] and [[gallstones]] (may cause [[gallstone pancreatitis]], [[Mirizzi syndrome]] | 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]]<ref name=pmid7914773>{{Cite journal | last1 = Hsu | first1 = YB. | last2 = Yu | first2 = SC. | last3 = Lee | first3 = PH. | last4 = Wei | first4 = TC. | title = An uncommon cause of biliary obstruction (Mirizzi syndrome): report of five cases. | journal = J Formos Med Assoc | volume = 93 | issue = 4 | pages = 314-9 | month = Apr | year = 1994 | doi = | PMID = 7914773 }}</ref>). | ||
==Specimen opening== | ==Specimen opening== | ||
| Line 20: | Line 20: | ||
Appearance: | Appearance: | ||
*Serosal surface: [tan and smooth/rough]. | *Serosal surface: [tan and smooth/rough]. | ||
*Lumen contains: [thick green bile/multiple [yellow/green/black] calculi]. | *Lumen contains: [thick green bile/[one/multiple] [yellow/green/black] [calculus/calculi]]. | ||
*Mucosa: [dark green and velvety/granular, hemorrhagic/strawberry-like]. | *Mucosa: [dark green and velvety/granular, hemorrhagic/strawberry-like]. | ||
*Polyp/tumour: [not identified/___ cm in maximal dimension]. | *Polyp/tumour: [not identified/___ cm in maximal dimension]. | ||
*Wall: [pliable/firm]. | *Wall: [pliable/firm]. | ||
*Neck: [pliable/firm]. | *Neck: [pliable/firm]. | ||
*Cystic duct: [patent/not patent]. | *Cystic duct: [patent/not patent because it [contain calculus/___]]. | ||
*Cystic duct lymph node: [not identified/present, measuring ___ cm in greatest dimension]. | *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. | *Representive sections of the neck, body and fundus, including the cystic duct lymph node, are submitted in one cassette. | ||
===Protocol notes=== | ===Protocol notes=== | ||
*High-grade [[gallbladder dysplasia|dysplasia]] ''should'' prompt submitting the gallbladder in total, if cancer is not present.<ref name=uscap2017_akki/> | |||
*[[Intestinal metaplasia of the gallbladder]] does ''not'' have to be [[submitted in total]].<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> | |||
====Staging==== | ====Staging==== | ||
===Alternate approaches=== | ===Alternate approaches=== | ||
==See also== | ==See also== | ||
===Related protocols=== | ===Related protocols=== | ||
==References== | ==References== | ||
{{Reflist|1}} | {{Reflist|1}} | ||
==External links== | ==External links== | ||
[[Category:Gross pathology]] | [[Category:Gross pathology]] | ||
Latest revision as of 21:20, 22 June 2017
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/[one/multiple] [yellow/green/black] [calculus/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 because it [contain calculus/___]].
- 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.