Ultrasonic diagnosis of primary carcinoma of the gallbladder: A review of 16 cases

Abstract

Sonographic findings in 16 patients (10 women, six men) with surgically documented gallbladder carcinoma are reported. Two principal forms are described: localized infiltrating, or fungating, tumors (eight patients) and diffuse tumors infiltrating the entire gallbladder wall (eight patients). In all cases, the tumors were adenocarcinomas. Eleven patients also had cholelithiasis. Contiguous extension and metastasis did not correlate with tumor size. The difficulties encountered an the differential diagnosis are discussed in relation to the different sonographic appearances.

“Adenomatous Polyps of the Gallbladder” Adenomas of the Gallbladder

“…Tsuchiya and Uchimura15, in a collective review of small polypoid lesions of the gallbladder from 15 japanese institutions, reported a 6 per cent incidence of carcinoma in lesions less than 1.0 cm, while the incidence of carcinoma increased to 37.5 per cent in those 1.0-2.0 cm. Moreover, Kozuka et 16 failed to demonstrate correlation between size of the neoplastic lesion and extension, the study of Koga et al 2 clearly indicated a close correlation of depth of invasion and extent of spread to the enlargement of the lesion. …”

Diagnosis of Gallbladder Diseases by Contrast-Enhanced Phase-Inversion Harmonic Ultrasonography

“…It is important that gallbladder cancers are detected early because the prognosis for advanced gallbladder cancer is poor (Ruiz et al 1980;Hederstrom and Forsberg 1987;Yeh 1979;Ishikawa et al 1989;Koga et al 1985Koga et al , 1988Yang et al 1992). It has been proposed that color Doppler sonography and contrast-enhanced power Doppler US are useful techniques for diagnosing hepatic, pancreatic and gallbladder diseases (Ding et al 2001a;Sato et al 2001;Hayakawa et al 1998;Kim et al 2002;Komatsuda et al 2000).…”

Ultrasonography in Carcinoma of the Gallbladder

“…CT and US, have greatly facilitated the visualization of the gallbladder and adjacent structures but have hardly been successful in detecting the disease in its early and curable stage (6,14); results also confirmed in this investigation. The diagnostic dilemma seems to emanate partly from the non-specificity of pathologic findings which are consistent both with benign inflammatory gallbladder disease and GBCA (4,11,13,17).…”

“…GBCA was diagnosed according to earlier described criteria (I,5,7,II,13,16): I) A solid mass of mixed and irregular echo-structure replacing the gallbladder, 2) a papillary mass with irregular borders projecting from the gallbladder wall, 3) thickening of the gallbladder wall showing either diffuse or localized irregularity often containing stones, and 4) mixed pattern 1-3.…”