scholarly journals Gall bladder carcinoma: the facts and the mimics

Author(s):  
Niharika Prasad ◽  
Saugata Sen

Abstract Background Gall bladder carcinoma (GBC) is the most common biliary epithelial neoplasm. Its slow progression and late presentation lend it a poor prognosis. The risk factors can be divided into cholelithiasis, inflammatory causes, infection, exposure, and gall bladder pathologies. It usually spreads by hematogenous or lymphatic route or directly invades the liver. There are many controversies related to guidelines for management of gall bladder polyps and treatment options. Main text This review article attempts to give definitive guidelines for the same and helps the reader distinguish it from other benign mimickers. The emerging role of newer modalities like contrast ultrasound, elastography, and magnetic resonance cholangiopancreatography has also been briefly mentioned. This paper reviews the literature to provide concise background, etiopathogenesis, radiological findings, and management options of GBC. Conclusions Out of all the available modalities MDCT, FDG-PET CT, and image-guided biopsies play the most important role in diagnosis and follow-up. Imaging remains elementary in pre-operative planning and management of gall bladder neoplasms.

2020 ◽  
Vol 4 (3) ◽  
pp. 105-108
Author(s):  
Priti Meena ◽  
Vinant Bhargava ◽  
Devinder Singh Rana ◽  
Anil Kumar Bhalla ◽  
Ashwani Gupta ◽  
...  

Background: C3 glomerulopathy is caused by dysregulation of the alternative complement pathway. Association with solid organ tumors is rare. However, there have been a few case reports of membranoproliferative glomerulonephritis secondary to gastrointestinal neoplasms. Case: A 38-year-old female presented with abdominal distension, loss of appetite, amenorrhea, and easy fatigability. She had been diagnosed 8 months back with C3 glomerulopathy and had received immunosuppression. On evaluation, she was incidentally detected to have Krukenberg tumor. The primary site of malignancy was gall bladder. Conclusion: Our case report highlights a possible association between C3 glomerulopathy and Krukenberg tumor secondary to gall bladder carcinoma and emphasizes the fact that even in cases of C3 glomerulopathy, occult malignancy should be considered as an underlying pathology.


Author(s):  
Dharmpal Godara ◽  
Vijay Pal Singh Dhayal

Background: The present study highlights the occurrence of Incidental gallbladder carcinoma (IGBC) detected during histopathological examination in cholecystectomy specimens removed for cholelithiasis. Methods- This is a tertiary hospital based cross-sectional study of 500 cholecystectomy specimens removed during cholelithiasis. Relevant hospital records, histopathology slides and reports were reviewed, re-evaluated and studied. Results: 4(0.80%) cases of incidental gall bladder carcinoma (IGBC) were diagnosed from the histopathological evaluation (HPE) of 500 cholecystectomy specimens, constituting 0.80% of gall bladder specimens received during the study period. The age of the patients with IGBC ranged from 51-80 years. More females were affected than males with a M:F ratio of 1:3. Conclusion: Early detection of IGBC by histopathological examination would have a favourable impact on prognosis and management thereby increasing the survival outcome. Keywords: Cholelithiasis, Incidental Gall Bladder Carcinoma


2017 ◽  
Vol 8 (2) ◽  
pp. 105-111
Author(s):  
Nusrat Ghafoor ◽  
Naffisa Abedin ◽  
AS Mohiuddin

Background & objective: Ultrasonogram (USG) and computed tomography (CT) are often used in the evaluation of gall-bladder carcinoma. Thepresent study was conducted to determine the usefulness of USG and CT scan in diagnosing gallbladder carcinoma.Materials & Methods: This cross-sectional observational study was conducted at Department of Radiology and Imaging, BIRDEM in collaboration with the Departments of Hepato-biliary Surgery, and Histopathology of the same institute over a period of 3 years fromJuly 2004 to June 2006. A total of 42 patients (ranging from 40-80 years) were initially included on the basis of signs and symptoms of gallbladder carcinoma and underwent USG and CT scan for preoperative radiological diagnosis, its extension and operability. Following operation all the resected specimens were sent for histopathological evaluation. The diagnostic accuracies of USG and CT scan were then compared against histopathological diagnoses by using Kappa statistics.Result: In the present study, the mean age of the patients was 60 (range: 40-80) years with female preponderance. About 40% of the gall-bladder were contracted and reduced in size and 32.5% large and distended on USG examination, while 45% of the gall-bladder were contracted and reduced in size and 25% distended and large on CT examination. Approximately 40% had irregularly thickened wall and 21.2% diffusely thickened wall on USG and 30% of gallbladder wall were diffusely thickened and 45% irregularly thickened on CT scan. The present study showed hepatic parenchymal invasion to be 22.5% on USG and 42.5% on CT scan. The sensitivity and specificity of USG in diagnosing GB carcinoma were 93.9 and 71.4% respectively. Similarly, the sensitivity and specificity of CT scan in detecting GB carcinoma were 97.1 and 83.3% respectively. The test of agreement (Kappa test) revealed an almost 90% agreement between the two procedures meaning that the two diagnostic modalities are almost comparable in diagnosing gall bladder carcinoma (p<0.001).Conclusion: The study findings indicate that both USG and CT scan are ideal,non-invasive, safe imaging modalities for diagnosis of gallbladder carcinoma. CT scan has an additional advantage in defining the extension of the disease and involvement of surrounding structures including lymph nodes and hepatoduodenal ligament.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 105-111


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