Difference between revisions of "Gallbladder adenoma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
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| Synonyms = | |||
| Micro = | |||
| Subtypes = | |||
| LMDDx = [[adenocarcinoma of the gallbladder]], reactive changes - as may be seen in [[acute cholecystitis]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = [[gallbladder grossing]] | |||
| Staging = | |||
| Site = [[gallbladder]] | |||
| Assdx = | |||
| Syndromes = [[familial adenomatous polyposis]], [[Peutz-Jeghers syndrome]] | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
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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]].<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><ref name=pmid33629395/> | |||
DDx: | |||
*[[Gallbladder adenocarcinoma]]. | |||
*Reactive changes. | |||
===Grading dysplasia=== | |||
Low grade dysplasia:<ref name=pmid33629395>{{cite journal |authors=Roa JC, Basturk O, Adsay V |title=Dysplasia and carcinoma of the gallbladder: pathological evaluation, sampling, differential diagnosis and clinical implications |journal=Histopathology |volume=79 |issue=1 |pages=2–19 |date=July 2021 |pmid=33629395 |doi=10.1111/his.14360 |url=}}</ref> | |||
*Surface epithelium changes: hyperchromasia, pseudostratification, elongated nuclei; nuclei stratified/confined mainly to lower aspect of the epithelium. | |||
High grade dysplasia:<ref name=pmid33629395/> | |||
*Diffuse and severe (cytologic) atypia: nuclei no long stratified. | |||
===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]]. | |||
*[[Intestinal metaplasia of the gallbladder]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Gastrointestinal pathology]] | |||
Latest revision as of 14:50, 15 August 2024
| Gallbladder adenoma | |
|---|---|
| Diagnosis in short | |
| LM DDx | adenocarcinoma of the gallbladder, reactive changes - as may be seen in acute cholecystitis |
| Grossing notes | gallbladder grossing |
| Site | gallbladder |
|
| |
| Syndromes | familial adenomatous polyposis, Peutz-Jeghers syndrome |
|
| |
| Prevalence | uncommon |
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).
Sign out
GALLBLADDER, CHOLECYSTECTOMY: - BILIARY TYPE TUBULAR ADENOMA WITH HIGH GRADE DYSPLASIA. - MARGINS CLEAR OF ADENOMA (NEAREST MARGIN 1.0 CM).
See also
References
- ↑ 1.0 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.