Adenocarcinoma ; pathology ; Gallbladder Neoplasms ; pathology ; Humans

Adult ; Gallbladder Diseases ; pathology ; Gastric Mucosa ; pathology ; Humans ; Male

Humans ; Gallbladder Neoplasms/pathology* ; Liver Neoplasms/pathology* ; Immunotherapy

PURPOSE: Gallbladder cancer had poor prognosis because it is usually detected at a late stage. Some GB polyps are diagnosed as cancerous on the postoperative pathology. Because of the significance of the early detection of the cancer, the relationship between GB polyp and cancer is important. METHODS: From January 1994 to May, 2004, 94 cases of GB polypoid lesions were identified and diagnosed after cholecystectomy was performed at the Korea University Medical Center Anam hospital. The pateints' age, gender, the symptoms and signs, the diagnostic tools, the operative methods and the histopathologic findings were investigated. RESULTS: For the 94 patients, the mean age was 50.3+/-13.1 years and there were 42 males (44.7%). 92 patients were evaluated by abdominal ultrasonography, and it had a sensitivity of 72.8%. On the histopathologic results, there were 76 cases of benign polyps and 18 cases of malignant polyps. The diameter of the malignant polyps was 17.3+/-8.5 mm and the diameter of the benign polyps was 6.4+/-3.0 mm, so the malignant polyps were larger than the benign polyps. The mean age of the malignant polyp group was 62.6+/-14.2 years and the mean age of the benign polyp group was 47.1+/-11.1. The patients of the malignant polyp group were older than the patients of the benign polyp group. 19 GB polyps were greater than 10 mm in diameter and among them, there were 15 cases of malignant polyps (78.94%). CONCLUSION: The size of the polyps and the patient's age could be risk factors for malignant polyps, and the malignant potential was high for the polyps that exceeded 10 mm and for a patient age that exceeded 60 years. Surgical treatment is recommended for these patients.
Academic Medical Centers ; Cholecystectomy ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Korea ; Male ; Pathology ; Polyps* ; Prognosis ; Risk Factors ; Ultrasonography

PURPOSE: To correlate SOhographic and pathologic findings of gallbladder adenoma, and to evaluate the clinical significance of sonographic findings. MATERIALS AND METHODS: Ultrasound findings of twenty gallbladder adenomas were retrospectively reviewed to evaluate the size, shape and echogenicity of the adenoma, and was correlated with the pathological finding. RESULTS: Among 14 patients, 11 patients had single lesion and 3 patients had multiple lesions. Three patients showed 2, 3 and 4 adenomas, respectively. Nine of 20 lesions showed focal dysplasia pathologically. Among the nine adenomas with dysplasia, two adenomas showed focal cancerous change. The nine adenomas showing focal dysplasia measured 25.6mm (14-35mm) in mean diameter, while the mean diameter of adenomas without dysplasia was 8.7 mm (3-13mm). The echogenicity of adenoma with focal dysplasia were hyperechoic in 8, isoechoic in 1. The echogenicity of adenomas without dysplasia were hyperechoic in 7, isoechoic in 4. Sessile(7/9) and papillary shape(6/9) were predominant in adenoma with dysplasia, but smooth shape(8/11) and stalked type(9/11) were predominant in adenoma without dysplasia. Two adenomas with focal cancerous change showed histological transition from cancer to dysplasia and to adenomatous tissue. In adenoma with dysplasia, the diameter more than 14 mm on sonography was statistically significant (p<0. 005). Also age of patient was significantly different between the two groups (p<0.01), while echogenicity and associated stone were not statistically significant. CONCLUSION: As gallbladder adenoma more than 14ram in diameter on US is suggestive of dysplasia on pathology, so, close follow up US or surgery is recommended.
Adenoma* ; Follow-Up Studies ; Gallbladder* ; Humans ; Pathology ; Retrospective Studies ; Ultrasonography

The polypoid lesions of gallbladder have explosively increased with enhanced feasibility of transabdominal ultrasonography. Most of small polyps less than 10 mm are benign and remain static for a long period. In small polyps, three to six month intervaled ultrasonography is warranted in the initial follow-up, but the duration of follow-up period is not clarified. The polypoid lesions larger than 10 mm show a quite different feature. They showed a remarkable risk of malignancy (34-88%) and should be treated by surgery. Furthermore, age more than 50 years and combined gallstone are important factors predicting malignancy in polypoid lesions of gallbladder. In addition, other factors including solitary polyp and the presence of symptoms are considered as risk factors. Laparoscopic cholecystectomy is a golden standard therapy for these polyps unless the suspicion of malignancy is high. The gallbladder polyps remain a problem of concern to both doctors and patient with the worry of malignancy. Thus, the comprehensive understanding of natural coruse of gallbladder polyp and risk factors of malignancy should be kept in mind.
Cholecystectomy, Laparoscopic ; Gallbladder Diseases/classification/*pathology/surgery ; Gallbladder Neoplasms/diagnosis ; Humans ; Polyps/classification/*pathology/surgery ; Risk Factors

Metastatic renal cell carcinoma is renowned for its potency to spread to almost any organ of the body; however metastasis to the gall bladder is very rare. We present a case of a 48 year old man who initially demonstrated renal cell carcinoma, and in who gallbladder metastasis was later detected. A review of the literature revealed only a small number of cases of renal cell carcinoma metastasizing to the gallbladder, and these were primary found upon necropsy. Gall-bladder metastasis in this case was detected clinically.
Carcinoma, Renal Cell/pathology/*secondary ; Gallbladder Neoplasms/pathology/*secondary ; Human ; Kidney Neoplasms/*pathology ; Male ; Middle Aged

Adenocarcinoma ; metabolism ; pathology ; surgery ; Aged ; Cholecystectomy ; Chondrosarcoma ; metabolism ; pathology ; surgery ; Female ; Gallbladder ; chemistry ; pathology ; surgery ; Gallbladder Neoplasms ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Keratin-3 ; metabolism ; S100 Proteins ; metabolism

OBJECTIVETo study the expression of ephrin-A7 (EphA7) and metadherin (MTDH) and their clinicopathological significances in the benign and malignant lesions of gallbladder.

METHODSEnVisiom immunohistochemical methods was used for determining the expressions of EphA7 and MTDH in routinely paraffin-embedded sections of surgically-resected specimens from 108 cases with gallbladder adenocarcinoma, 15 cases with adenomatous polyp and 35 cases with chronic cholecystitis treated from June 1996 to June 2006. And 46 cases of peritumoral tissues were also harvested as controls (n = 35).

RESULTSThe positive expression rates of EphA7 and MTDH were significantly higher in gallbladder adenocarcinoma than those in peritumoral tissues (χ(2)(EphA7) = 12.65, χ(2)(MTDH) = 13.00; P < 0.01), adenomatous polyp (χ(2)(EphA7) = 8.21, χ(2)(MTDH) = 9.39; P < 0.01) and chronic cholecystitis (χ(2)(EphA7) = 21.21, χ(2)(MTDH) = 23.68; P < 0.01); Moderately-or severely-atypical hyperplasia of gallbladder epithelium was found in the benign lesions with positive expression of EphA7 and/or MTDH. The positive rates of EphA7 and MTDH were significantly lower in the cases of well-differentiated adenocarcinoma, maximal diameter of tumor < 2 cm, no-metastasis of lymph node, and tumor with no-invasiveness of regional tissues than those in the poorly-differentiated adenocarcinoma (χ(2)(EphA7) = 12.34, χ(2)(MTDH) = 12.80; P < 0.01), maximal diameter of tumor ≥ 2 cm (χ(2)(EphA7) = 5.22, χ(2)(MTDH) = 5.00; P < 0.05), cases with metastasis of lymph node (χ(2)(EphA7) = 5.15, χ(2)(MTDH) = 5.86; P < 0.05) and cases with invasiveness of regional tissues (χ(2)(EphA7) = 7.06, P < 0.01; χ(2)(MTDH) = 4.13; P < 0.05) in gallbladder adenocarcinoma (P < 0.05). The high consistency was found between the expressive levels of EphA7 and MTDH in gallbladder adenocarcinoma (χ(2) = 13.11, P < 0.01). The univariate Kaplan-Meier analysis showed that the increased expression of EphA7 (P = 0.023) and MTDH (P = 0.034) was negatively associated with the overall survival. The multivariate Cox regression analysis showed that increased expression of EphA7 and/or MTDH (P(EphA2) = 0.023, P(MTDH) = 0.034) was an independent poor-prognostic predictor for gallbladder adenocarcinoma.

CONCLUSIONSThe expression of EphA7 and/or MTDH might be closely related to the carcinogenesis, progression, clinical biological behaviors and prognosis of gallbladder adenocarcinoma. The positive expression of EphA7 and/or MTDH may predict bad-prognosis in gallbladder adenocarcinoma.

Adult ; Aged ; Cell Adhesion Molecules ; metabolism ; Cholecystitis ; metabolism ; pathology ; Female ; Follow-Up Studies ; Gallbladder ; metabolism ; pathology ; Gallbladder Diseases ; metabolism ; pathology ; Gallbladder Neoplasms ; metabolism ; pathology ; Humans ; Male ; Middle Aged ; Polyps ; metabolism ; pathology ; Prognosis ; Receptor, EphA7 ; metabolism

PURPOSE: Gallbladder polyps have malignant potentials and there are no definitive treatment criteria. Therefore, to establish the appropriate treatment for gallbladder polyps, the gross and microscopic appearance of gallbladder polyps were studied and the clinical findings analyzed. METHODS: Between January 1990 and December 1999, 1108 subjects underwent open and laparoscopic cholecystectomy at our institute. Seventy nine subjects, confirmed to have gallbladder polyps by pathology, were analyzed. To establish the surgical indications of polyps with malignancy potential, gender, age, clinical symptoms, polyp size, numbers, shape, coexistence of stones and the pathological findings were analyzed. RESULTS: The mean age of the subjects with benign and malignant polyps were 44.2 and 55.2 years old, respectively (p=0.034). The mean maximum diameter in benign and malignant polyps were 6.4 and 19.8 mm, respectively (p= 0.029). There were single polyps in 52.6 (30/57) and 86.3% (19/22) of the benign and malignant lesions, respectively (p= 0.046). Comparing the clinical symptoms (abdominal discomfort. etc) between the two groups, benign polyps had 26.3% (15/57), malignant polyps had 86.3% (19/22) (p= 0.0032). Cholesterol polyps were found in 29 (36.7%), inflammatory or hyperplastic polyps in 11 (13.9%) adenomas in 17 (21.5%) and adenocarcinomas in 22 (27.9%) cases. There were no differences in the presence of stones or in the shape of the polyps. CONCLUSION: On the basis of our analysis, when the polyp is of the single type, over 15 mm in diameter and the patient was 50 years old or over, surgical intervention should be considered due to the high risk of malignancy. If surgical intervention is not appropriated, a close follow-up is generally recommended to monitor the changes in the polyp size and shape.
Adenocarcinoma ; Adenoma ; Cholecystectomy ; Cholecystectomy, Laparoscopic ; Cholesterol ; Follow-Up Studies ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Middle Aged ; Pathology ; Polyps