Imaging benign and malignant disease of the gallbladder

Gore, Richard M.; Yaghmai, Vahid; Newmark, Geraldine M.; Berlin, Jonathan W.; Miller, Frank H.

doi:10.1016/s0033-8389(02)00042-8

Cited by 145 publications

(104 citation statements)

References 70 publications

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“…Most common presentation is of a sub-hepatic mass replacing or obscuring the gall bladder (Fig.1) often with invasion of the adjacent liver [1][2][3]. This finding was seen in 28 (56%) of our cases with half of them in an inoperable stage of the disease, a feature reported in other studies also [7,8].…”

Section: Discussionsupporting

confidence: 65%

“…The closest association is with cholelithiasis, which is seen in 65 -95 % of patients as reported in different series. Other factors related are calcification of GB wall (porcelain GB), genetic factors, anomalous pancreatic biliary duct junction, infections and environmental carcinogens [1][2][3][4][5], of which the association with cholelithiasis is the most established [2]. In our study, 29(58%) patients had associated gallstones.…”

Section: Discussionmentioning

confidence: 66%

“…Patients of GB carcinoma present with complaints ranging from dyspepsia, malaise, weight loss, jaundice to lump abdomen [1,2]. Those with obstructive jaundice usually present in advanced stages of the disease [3] and the five year survival in such cases is less than 5% [4].…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 25% of carcinomas present as an intraluminal mass in the GB [1] (Fig.2). This finding was seen in 10 (20%) cases in this study.…”

Section: Discussionmentioning

confidence: 99%

“…C arcinoma of the gall bladder (GB) is the fifth most common malignancy of the gastrointestinal tract and the commonest malignancy of the biliary tree [1,2]. It occurs primarily in the sixth to seventh decade of life and is four to five times more common in women [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Computed Tomographic Findings in 50 Cases of Gall Bladder Carcinoma

George

Godara²,

Dhagat

et al. 2007

Medical Journal Armed Forces India

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Original Article Introduction C arcinoma of the gall bladder (GB) is the fifth most common malignancy of the gastrointestinal tract and the commonest malignancy of the biliary tree [1,2]. It occurs primarily in the sixth to seventh decade of life and is four to five times more common in women [2,3]. Ultrasonography (USG) and computed tomography (CT) have revolutionized the diagnosis and management of carcinoma GB. Magnetic Resonance Imaging (MRI) is utilized only in inoperable cases with obstructive jaundice for delineation of the biliary tract anatomy in patients considered for palliative stenting [3].USG in patients of carcinoma GB has certain limitations such as interference by bowel gas, limited depth resolution and inadequate visualization of parts of the gallbladder in the region of posterior acoustic shadowing in the presence of calculi. CT scan overcomes these drawbacks and provides definite information regarding invasion of the tumour into the adjacent organs, distant metastasis, delineation of the biliary tree and portal vein involvement. We present our experience of CT findings in 50 histologically proven cases of carcinoma GB. Material and MethodsThis retrospective study reviewed CT examination findings in 50 histopathologically proven (from operative specimen or fine needle aspiration cytology) cases of carcinoma GB over a period of two years. The patients presented with a wide spectrum of complaints ranging from dyspepsia, abdominal pain to clinically palpable lump abdomen and obstructive jaundice. All the patients were subjected to helical CT scan examination on a GE HiSpeed CT/i scanner.The CT protocol of 5mm helical CT sections in the axial plane at table speed of 5 mm/sec (pitch 1.0) with kV 120 and mA 280 was used. Breath-hold periods varied from 10 to 16 seconds with intervening breathing time of 8 seconds. The CT scan technique employed in our patients included a preliminary survey scan of the abdomen from levels of the diaphragm to the iliac crest after orally administered one litre of iodinated contrast (800 ml administered 45 minutes prior to and 200ml given just prior to the scan) for opacification of bowel during customized breath-hold phase. This was followed by repeat evaluation of the abdomen during dynamic intravenous injection of 80 ml of non-ionic iodinated contrast medium (300 mg Iodine/ml) for studying the lesional enhancement and vascular structures. Intravenous contrast medium was administered at the rate of 2 ml/sec using a pressure injector at 150 psi using a scan delay of 30 seconds to commence imaging. Suspected cases of duodenal involvement were subjected to targeted area scanning with patient in right decubitus position. ResultsThere was definite female preponderance with male: female Computed Tomographic Findings in 50 Cases of Gall Bladder CarcinomaLt Col RA George * , Col SC Godara + , Lt Col P Dhagat # , Maj PP Som ** Abstract Background : A retrospective assessment of contrast enhanced computed tomography (CECT) scan findings in histopathologically proven cases of c...

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

“…Approximately 25% of carcinomas present as an intraluminal mass in the GB [1] (Fig.2). This finding was seen in 10 (20%) cases in this study.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Computed Tomographic Findings in 50 Cases of Gall Bladder Carcinoma

George

Godara²,

Dhagat

et al. 2007

Medical Journal Armed Forces India

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Non-operative management of acute cholecystitis in the elderly

McGillicuddy

Schuster

Barre

et al. 2012

British Journal of Surgery

108

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Usefulness of lavage cytology during endoscopic transpapillary catheterization into the gallbladder in the cytological diagnosis of gallbladder disease

Naito

Okabe

Kawahara

et al. 2009

Diagnostic Cytopathology

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Many studies have reported methods of cell collection involving percutaneous transhepatic cholangiodrainage (PTCD) and fine-needle aspiration cytology for the diagnosis of gallbladder disease. However, few studies have described the use of a transpapillary approach, i.e., endoscopic transpapillary catheterization into the gallbladder (ETCG). In this study, we analyzed cells collected by ETCG to evaluate its usefulness in the cytological diagnosis of gallbladder disease. The subjects were 19 patients who had undergone ETCG for the diagnosis of gallbladder disease. Of these patients, 11 and 8 had gallbladder cancer and benign gallbladder disease, respectively. We also evaluated the diagnostic accuracy of PTCD cytology performed in 15 patients with gallbladder cancer.Specimens were cytologically diagnosed as normal or benign, indeterminate, suspected malignancy, malignant, and inadequate in 47% (9/19), 11% (2/19), 0% (0/19), 37% (7/19), and 5% (1/19) of patients, respectively. Specimens were diagnosed as malignant, indeterminate, normal or benign, and inadequate in 7, 2, 1, and 1, respectively, of the 11 patients diagnosed with gallbladder cancer. The sensitivity and specificity of ETCG cytology were 78 and 100%, respectively, whereas the diagnostic accuracy of PTCD cytology was 20% (3/15). None of the patients developed complications of ETCG. Despite its technical difficulty, ETCG for bile cytology allows the collection of adequate cell numbers from patients with benign disease or gallbladder cancer and facilitates a cytological diagnosis, making it a useful method for collecting cells.

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Imaging benign and malignant disease of the gallbladder

Cited by 145 publications

References 70 publications

Computed Tomographic Findings in 50 Cases of Gall Bladder Carcinoma

Computed Tomographic Findings in 50 Cases of Gall Bladder Carcinoma

Non-operative management of acute cholecystitis in the elderly

Usefulness of lavage cytology during endoscopic transpapillary catheterization into the gallbladder in the cytological diagnosis of gallbladder disease

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