scholarly journals Incidental Gallbladder Carcinoma in Gallbladder Polyps: Challenges of Gallbladder Malignancy for an Endemic Population

2021 ◽  
Vol 28 (1) ◽  
pp. 27-34
Author(s):  
Abhishek Gautam ◽  
Anshuman Pandey ◽  
Shakeel Masood ◽  
Smita Chauhan ◽  
Dinesh Choudhary ◽  
...  
Keyword(s):  
Gallbladder Carcinoma ◽  
Tnm Staging ◽  
Malignant Polyp ◽  
Tertiary Referral Centre ◽  
Gallbladder Polyps ◽  
Northern India ◽  
Cancer Group ◽  
Endemic Population ◽  
Benign Histology ◽  
Malignant Lesions

Background: Gallbladder polyps are considered pre-malignant lesions of gallbladder carcinoma. This study aims to highlight the role of early cholecystectomy in the management of gallbladder polyps in an endemic population. Methods: A retrospective analysis of 2,076 lap cholecystectomy procedures performed at the Department of Surgical Gastroenterology at a tertiary referral centre in Northern India was conducted and incidental malignancy in gallbladder polyps analysed. The 8th edition of the American Joint Committee on Cancer for tumour-node-metastasis (TNM) staging of gallbladder carcinoma was used. Results: Of 54 patients with gallbladder polyps, 53 had benign histology and one had malignant cells in the lamina propria suggestive of T1a adenocarcinoma. The patient with the malignant polyp was older (57 years old) than the patients in the non-cancer group, which had a mean age of 45 (P = 0.039). The size of the malignant polyp was approximately 4 mm, significantly smaller than the average 7.9 mm size of the benign polys (P = 0.031). Conclusion: Cholecystectomy needs to be considered early in the management of small- sized gallbladder polyps, particularly in areas endemic for gallbladder carcinoma.

scholarly journals Which is the best imaging method to diagnose gallbladder carcinoma in patients with asymptomatic gallbladder polyps?

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e475-e476
Author(s):  
L.P. Schneider ◽  
C.Y. Morioka ◽  
R. Chojniak ◽  
L.C. Serigiolle ◽  
H.M.P. Gomes ◽  
...  
Keyword(s):  
Gallbladder Carcinoma ◽  
Imaging Method ◽  
Gallbladder Polyps

Papillary lesions of the breast: Can larger core needle biopsy samples identify patients who may avoid surgical excision?

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 44-44
Author(s):  
Alice P. Chung ◽  
Kelly T. Huynh ◽  
Jaime Shamonki ◽  
Myung-Shin Sim ◽  
Camelia Lawrence ◽  
...  
Keyword(s):  
Core Needle Biopsy ◽  
Predictive Value ◽  
Needle Biopsy ◽  
Surgical Excision ◽  
Tissue Samples ◽  
Core Needle ◽  
Ductal Hyperplasia ◽  
Benign Histology ◽  
Papillary Lesions ◽  
Malignant Lesions

44 Background: Papillary lesions of the breast are frequently diagnosed on core needle biopsy (CNB). The ability to distinguish benign from atypical/malignant papillary lesions is limited by the representative nature of the biopsy method; thus follow-up excision is usually recommended. We aimed to determine if larger CNB samples can more reliably predict the true benign nature of a papillary lesion, thereby sparing certain patients a formal surgical excision. Methods: We reviewed medical records of 53 female patients diagnosed with histologically benign papillary lesions on CNB from 2000 to 2010, who subsequently underwent surgical excision. Pathology slides of the CNB were reviewed to document the benign histologic features of the papilloma, the number of cores sampled and the area of tissue biopsied (mm2). Statistical analysis was performed to identify the characteristics of the CNB that were associated with retention of benign histology on excision. Results: Atypical ductal hyperplasia (ADH) and carcinoma were identified in 6% (3/53) and 8% (4/53) of papillary lesions, respectively, when excised. Clinical and radiographic characteristics did not distinguish the ADH/malignant lesions from benign papillomas. The CNB needle sizes ranged from 9- to 18-gauge (median 14). The number of cores sampled ranged from 3-16 (mean 4.5). Patients with benign excisions had a significantly larger area of tissue sampled by CNB than those found to have ADH/malignant lesions on excision (mean ± SD: 95.6 ± 101.2 vs. 41.7 ± 21.9, respectively, p=0.003). By logistic regression, CNB tissue samples consisting of ≥7 cores, or measuring >96 mm2 in aggregate, had a negative predictive value for ADH/malignancy of 100% (AUC of 0.69 and 0.68, respectively). Conclusions: Although no clinical or radiologic features distinguished benign from pathologically significant papillary lesions, larger sample sizes significantly improved the predictive value of benign histology on CNB. A papilloma sampled by ≥ 7 cores or > 96 mm2 showing benign histology at CNB, retained benign features upon excision. Close surveillance may be a reasonable option for patients whose benign papillomas are generously sampled at the time of CNB.

Polyp on Ultrasound: Now What? The Association between Gallbladder Polyps and Cancer

2013 ◽  
Vol 79 (10) ◽  
pp. 1005-1008 ◽  
Author(s):  
Graham Donald ◽  
Dharma Sunjaya ◽  
Timothy Donahue ◽  
O. Joe Hines
Keyword(s):  
Preoperative Diagnosis ◽  
International Classification Of Diseases ◽  
High Grade Dysplasia ◽  
High Grade ◽  
Gallbladder Polyps ◽  
Cancer Group ◽  
Asymptomatic Patients ◽  
Classification Of Diseases ◽  
Risk Of Malignancy

The association between gallbladder polyps (GBP) and gallbladder cancer (GBC) is unclear. We sought to determine the association between preoperative diagnosis of GBP on imaging and GBC. A retrospective review of patients over 9 years was conducted using International Classification of Diseases, 9th Revision codes for GBP and GBC who underwent cholecystectomy at our institution. Demographics, imaging findings, and pathology results were recorded. A total of 2416 patients underwent cholecystectomy during the study period. Twenty-seven had an operation for GBP either as a result of concern for size or symptoms. Polyp sizes were categorized as less than 1 cm, 1 to 2 cm, or 2 cm or greater. Twenty-four patients in this group (88.9%) had no evidence of high-grade dysplasia or cancer and all of these benign polyps were 2 cm or less on imaging. One patient with a 2.4-cm polyp had high-grade dysplasia, and two patients with polyps over 3 cm had adenocarcinoma. During the same period, 20 patients had an operation for GBC with two patients common to the polyp group. The group of patients with noncancerous polyps was significantly younger than the cancer group (polyps and no polyps). The cancer group was more likely to be symptomatic. Therefore, polyps over 2 cm should be removed given the risk of high-grade dysplasia and cancer above this size. Polyps less than 2 cm were not associated with high-grade dysplasia or cancer and thus surgery may not be required. Intermediate- and small-sized polyps can be monitored with serial ultrasound, especially in younger, asymptomatic patients in whom the risk of malignancy is low.

scholarly journals Predictive value of neutrophil-to-lymphocyte ratio in diagnosis of early prostate cancer among men who underwent Robotic transperineal prostate biopsy

2019 ◽  
Author(s):  
Du Jingzeng ◽  
Ee Jean Lim ◽  
Hong Hong Huang ◽  
Weber Kam On Lau
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Predictive Value ◽  
Full Blood Count ◽  
Diagnostic Purpose ◽  
Transperineal Prostate Biopsy ◽  
Cancer Group ◽  
Significant Difference ◽  
Benign Histology ◽  
Benign Group

Abstract Background： NLR is known to have prognostic value for metastatic prostate cancer. However for early-localized prostate cancer due to lack of systemic response; the role of NLR is not conclusive. In this study we aim to evaluate the predictive value of NLR for early clinical indolent prostate cancer in patients who underwent robotic transperineal prostate biopsy (RTPB). Methods: Patients who underwent RTPB under general anesthesia, at Urology Department, Singapore General Hospital between Sep 2006 and Feb 2016 were retrospectively reviewed. NLR was calculated for all patients using full blood count (FBC) that was done as pre-admission test before GA within 4 weeks before operation. And NLR values were compared between prostate cancer (PCa) and benign group. Results: A total 652 patients who underwent RTPB for diagnostic purpose with valid PSA level were included in this study. There were total 409 (62.7%) benign histology and 243 (37.3%) prostate cancer. There was no significant difference of median NLR between benign and prostate cancer group (2.00 vs. 1.99; P=0.29). In the subgroups analysis, there were also no significant difference of median NLR value in clinical significant cancer (defined as Gleason 3 + 4 and above) and benign histology group (NLR 2.00 vs. 2.01, P=0.41), as well as prostate cancer and benign group according to different pre-biopsy PSA levels: PSA (ug/l) < 4, 4-10,10-20 and > 20, respectively. (Median NLR 1.34 vs. 1.76; 1.97 vs. 1.97; 1.97 vs. 2.18; 2.18 vs. 1.98, P>0.05) Conclusion: There were no statistical significant difference of NLR between benign and prostate cancer group as a whole or in the subgroup analyses for patients who underwent robotic transperineal prostate biopsy. NLR may have a limited role in predicting early stage prostate cancer.

Nasopharyngeal Masses in Adults

1983 ◽  
Vol 92 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Steven B. Hopping ◽  
Max L. Goodman ◽  
Jeanne D. Keller ◽  
William W. Montgomery
Keyword(s):  
Computed Tomography ◽  
Conventional Radiography ◽  
Benign Lesions ◽  
Cervical Mass ◽  
Computed Tomography Scans ◽  
Benign Histology ◽  
Malignant Lesions ◽  
One Year ◽  
High Index Of Suspicion ◽  
Nasopharyngeal Masses

Nasopharyngeal masses in adults present a perplexing problem because of the concern for malignancy. A retrospective review of the records, radiographs and biopsy histology of 57 patients presenting in one year with nasopharyngeal masses at the Massachusetts Eye and Ear Infirmary suggests that persistent pain, epistaxis, trismus, or cervical mass are uncommon in patients with benign histology and should alert the clinician to the probability of malignancy. A high index of suspicion on the part of the clinician is essential for the successful recognition of early lesions. The roles of conventional radiography, polytomography, and computed tomography scans are discussed. Patients with malignant lesions are contrasted with those having benign lesions.

scholarly journals PSCA and Oct-4 Expression in the Benign and Malignant Lesions of Gallbladder: Implication for Carcinogenesis, Progression, and Prognosis of Gallbladder Adenocarcinoma

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Qiong Zou ◽  
Leping Yang ◽  
Zhulin Yang ◽  
Jiangsheng Huang ◽  
Xi Fu
Keyword(s):  
Stem Cells ◽  
Overall Survival ◽  
Chronic Cholecystitis ◽  
Gallbladder Epithelium ◽  
Invasive Potential ◽  
Tumor Mass ◽  
Gallbladder Polyps ◽  
Node Metastasis ◽  
Gallbladder Adenocarcinoma ◽  
Malignant Lesions

PSCA and Oct-4 have been thought as markers of cancer stem cells. Although overexpression of PSCA and Oct-4 in cancer has been reported, little is known about the clinical and pathological significance with PSCA and Oct-4 expression in gallbladder adenocarcinoma. In this study, overexpression of PSCA and Oct-4 was detected in gallbladder adenocarcinoma (54.6% and 55.6%). Less expression of PSCA and Oct-4 was detected in the pericancerous tissues (19.6% and 21.7%), gallbladder polyps (13.3% and 13.3%), and gallbladder epithelium with chronic cholecystitis (14.3% and 14.3%). The overexpression of PSCA and Oct-4 was significantly associated with differentiation, tumor mass, lymph node metastasis, invasion of gallbladder adenocarcinoma, and decreased overall survival. Our study suggested that overexpression of PSCA and Oct-4 might be closely related to the carcinogenesis, progression, metastasis, or invasive potential and prognosis of gallbladder carcinoma.

scholarly journals Predictive value of neutrophil-to-lymphocyte ratio in diagnosis of early prostate cancer among men who underwent Robotic transperineal prostate biopsy

2020 ◽  
Author(s):  
Du Jingzeng ◽  
Ee Jean Lim ◽  
Hong Hong Hong Huang ◽  
Kam On Weber Kam On Lau
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Predictive Value ◽  
Gleason Grade ◽  
Early Prostate Cancer ◽  
Transperineal Prostate Biopsy ◽  
Cancer Group ◽  
Significant Difference ◽  
Benign Histology ◽  
Benign Group

Abstract Background NLR is known to have prognostic value for metastatic prostate cancer (PCa). However for early PCa due to lack of systemic response; the role of NLR is not conclusive. In this study we aim to evaluate the predictive value of NLR for early clinical PCa in patients who underwent robotic transperineal prostate biopsy (RTPB). Methods Patients who underwent RTPB under general anesthesia (GA), at the Department of Urology, Singapore General Hospital between Sep 2006 and Feb 2016 were retrospectively reviewed. Exclusion criteria includes: 1. Patients with missing value of PSA NLR 2. Patients who underwent biopsy for non-diagnostic purposes. 3. Patients with chronic inflammation or high grade prostatic intraepithelial neoplasia. Patients who had more than one biopsies and only the last histology results were included in this study. NLR was calculated for all patients using Complete blood count that was done as pre-admission test before GA within 4 weeks before operation. NLR values were compared between PCa; clinical significant PCa and benign group. Patients were divided further into different groups according to PSA level for subgroup analysis. Results A total 652 patients who underwent RTPB for diagnostic purpose with valid pre-procedure PSA level were included in this study. There were total 409 (62.7%) benign histology and 243 (37.3%) PCa cases. Median NLR in the benign histology group and PCa group were 2.00 and 1.99. There was no statistically significant (P=0.29). In the subgroups analysis, there were also no significant difference of median NLR value in clinical significant cancer group (defined as Gleason 3 + 4 and above) when compared to benign group (NLR 2.00 vs. 2.01, P=0.41) as well as in prostate cancer group and benign group according to different pre-biopsy PSA levels (PSA < 4, 4-10, 10-20 and > 20 ug/L), respectively. (P>0.05). NLR is not a significant predictor for Gleason grade group and D’Amico risk stratification group. (P>0.05) Conclusion There were no statistical significant difference of NLR between benign and prostate cancer group as a whole or in the subgroup analyses for patients who underwent RTPB. NLR may have a limited role in predicting early prostate cancer.

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