scholarly journals Role of ultrasonography in the diagnosis of gall-bladder carcinoma: A boon for low-resource settings

2018 ◽  
Vol 04 (01) ◽  
pp. 001-005
Author(s):  
Sachin Khanduri ◽  
Aakshit Goyal ◽  
Tarim Usmani ◽  
Shreshtha Jain ◽  
Arun Goyal ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Bladder Carcinoma ◽  
False Positive ◽  
Imaging Modality ◽  
Advanced Stage ◽  
Gall Bladder Carcinoma ◽  
Predictive Values ◽  
Low Resource Settings ◽  
Low Resource ◽  
Early Stages

Abstract Purpose: The present study was done with an aim to evaluate the usefulness of ultrasonography (USG) in early diagnosis of gall-bladder carcinoma for low-resource settings. Materials and Methods: A total of 264 clinically suspicious cases were enrolled in the study. The patients underwent USG followed by computed tomography (CT). Histopathological specimens were obtained from 208 cases. Final diagnosis was confirmed histopathologically/CT. Sensitivity, specificity, positive predictive, and negative predictive values of USG were calculated. Results: A total of 29 cases were confirmed as gall-bladder carcinoma, 58.6% were diagnosed at advanced stage (Stage III/IV). USG diagnosed 42 cases as neoplastic, however, 24 were true positive and 18 were false positive. USG was 82.8% sensitive and 92.5% specific. The positive and negative predictive values were 57.1% and 97.8%, respectively, diagnostic efficacy was 91.5%. 94.1% advanced stage gall bladder cancers were diagnosed correctly by USG. Sensitivity for early stages was promising (61.9%), however false positive was higher. Cost of USG was nearly five times lesser as compared to that of CT. Conclusion: USG was a useful economical imaging modality for the screening of gall bladder cancer in low-resource settings, especially for advanced stages. However, for early stages too, it seemed useful. We recommend to encourage the use of USG in early detection of gall-bladder carcinoma in socially and economically disadvantaged settings.

scholarly journals EGFR and HER2neu Expression in Gall Bladder Carcinoma and Its Association with Clinicopathological Parameters - An Institutional Experience from North India

2021 ◽  
Vol 6 (1) ◽  
pp. 57-65
Author(s):  
Inara Abeer ◽  
Sabina Khan ◽  
Mohd. Jaseem Hasan ◽  
Musharraf Hussain
Keyword(s):  
Gall Bladder ◽  
Bladder Carcinoma ◽  
North India ◽  
Clinicopathological Parameters ◽  
Advanced Stage ◽  
Gall Bladder Carcinoma ◽  
Egfr Expression ◽  
Poorly Differentiated ◽  
Well Differentiated ◽  
Biliary Tract Malignancy

Objective: Gallbladder cancer (GBC) is the most common biliary tract malignancy found worldwide with very high incidence in North India especially Delhi region. It is characterized by poor prognosis and ineffective treatment especially in advanced stage. The aim of this study was to evaluate EGFR and HER2/neu immunoexpression in cancer patients and to correlate it with the clinicopathological parameters so as to identify GBC patients who can benefit from targeted therapy.Methods: Present study was conducted in the Department of Pathology, Hamdard Institute of Medical Sciences & Research, New Delhi. A total of 40 cases of Gallbladder carcinoma (GBC) were evaluated for Immunohistochemical expression of EGFR and HER2/neu. Clinicopathological parameters of GBC were studied and correlated with immunoexpression of EGFR and HER2 /neu. Result: The mean age of the GBC patients was 55.9 years with 90% being females. On histopathology, 34(85%) cases were conventional adenocarcinoma. The EGFR expression was positive in 29/40 cases (72.5%). It was significantly more positive in poorly differentiated grade and advanced stages of gall bladder carcinoma (P<0.05). The expression of HER2/neu was positive in 13/40 cases (32.5%). It was significantly more positive in well differentiated gall bladder carcinoma (P<0.05). Immunoexpression of EGFR was inversely related with HER2/neu expression and this association was statistically significant.Conclusion: Among GBC patients, EGFR expression and HER2/neu expression was 72.5% and 32.5%, respectively. Significant EGFR expression was seen in poorly differentiated and advanced stage cancers while significant HER2/neu expression was seen in well differentiated gall bladder carcinomas. To conclude, these two markers HER2/neu and EGFR can be used as predictive and prognostic markers respectively, with rationale to further explore the use of anti-HER2 and anti- EGFR therapy in gall bladder cancer.

scholarly journals Role of Tumour Markers Carbohydrate Antigen 19-9, Carcinoembryonic Antigen, & Alpha Fetoprotein in Carcinoma Gall Bladder

2021 ◽  
Vol 10 (10) ◽  
pp. 719-723
Author(s):  
Saurabh Rai ◽  
Chandra Shekhar ◽  
Osman Musa ◽  
Nisar Ansari ◽  
Rahul Agrawal ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Carcinoembryonic Antigen ◽  
Bladder Carcinoma ◽  
Carbohydrate Antigen ◽  
Tumour Markers ◽  
Alpha Fetoprotein ◽  
Advanced Stage ◽  
Gall Bladder Carcinoma ◽  
Carcinoma Gall Bladder

BACKGROUND Gallbladder cancer is recognised as an irreversible malignancy with a high fatality rate. The highest incidence of gall bladder carcinoma is seen in India and Chile, and relatively low level in many Western countries. Gall bladder carcinoma has an extremely poor prognosis, increasing incidence, and diagnosed at an advanced stage despite recent advances in diagnostic modalities. Considering the high rate of mortality attributable mainly to late detection of disease at an advanced stage, early diagnosis remains to be one of the most important determinants of the outcome. This study was conducted to assess the role of tumour markers, namely carbohydrate antigen (CA 19-9), carcinoembryonic antigen (CEA) and alpha fetoprotein (AFP) in the diagnosis of gall bladder carcinoma. We wanted to assess the diagnostic role of tumour markers in carcinoma gall bladder. METHODS Patients with radiologically and histopathologically confirmed diagnosis of carcinoma gall bladder were invited to participate in the study. A thorough history was taken, and relevant examination done as per protocol. All necessary laboratory and radiologic investigations were done according to study design. Assessment of the tumour markers CA19-9, CEA and AFP was done, and values compared with carcinoma gall bladder patients. RESULTS The diagnostic value of tumour markers has been studied in context with histopathological grade as all the cases were histopathologically proven cases of carcinoma gall bladder (Ca GB). CONCLUSIONS The present study showed that CA 19-9 was most effective with regard to its ability to differentiate between different grades of gall bladder carcinoma. KEY WORDS CA 19-9, CEA, AFP, Carcinoma Gallbladder

Krukenberg tumor secondary to gall bladder carcinoma masquerading C3 glomerulopathy

2020 ◽  
Vol 4 (3) ◽  
pp. 105-108
Author(s):  
Priti Meena ◽  
Vinant Bhargava ◽  
Devinder Singh Rana ◽  
Anil Kumar Bhalla ◽  
Ashwani Gupta ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Bladder Carcinoma ◽  
Case Reports ◽  
Abdominal Distension ◽  
Gastrointestinal Neoplasms ◽  
Solid Organ ◽  
Krukenberg Tumor ◽  
C3 Glomerulopathy ◽  
Gall Bladder Carcinoma ◽  
Loss Of Appetite

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.

INCIDENTAL GALL BLADDER CARCINOMA (IGBC) IN CHOLECYSTECTOMY SPECIMENS REMOVED FOR CHOLELITHIASIS

2021 ◽  
Vol 5 (10) ◽  
Author(s):  
Dharmpal Godara ◽  
Vijay Pal Singh Dhayal
Keyword(s):  
Gall Bladder ◽  
Bladder Carcinoma ◽  
Histopathological Examination ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Survival Outcome ◽  
Sectional Study ◽  
Gall Bladder Carcinoma ◽  
Cross Sectional ◽  
Hospital Records

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

scholarly journals Role of Ultrasound and Computed Tomography in the Evaluation of Gallbladder Malignancy

2017 ◽  
Vol 8 (2) ◽  
pp. 105-111
Author(s):  
Nusrat Ghafoor ◽  
Naffisa Abedin ◽  
AS Mohiuddin
Keyword(s):  
Computed Tomography ◽  
Gall Bladder ◽  
Ct Scan ◽  
Sensitivity And Specificity ◽  
Gallbladder Carcinoma ◽  
Bladder Carcinoma ◽  
Biliary Surgery ◽  
Gall Bladder Carcinoma ◽  
Additional Advantage ◽  
Thickened Wall

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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