13 patients with the gallbladder cancer diagnosed by ultrasound in which 6 patients received CT scanner, these images compared with the operational results and pathological anatomy. The gallbladder cancer occurred most frequently in the elderly and had the poor prognosis. The ultrasound showed the unfair thickness of gallbladder wall (66.7%) rough tumor from the posterior wall to gallbladder
Gallbladder Neoplasms ; Ultrasonography ; Diagnosis

Multiple synchronous malignancies are defined as the occurrence of two or more primary malignant tumors whose pathogenetic processes are believed to be independent or unrelated. Multiple synchronous biliary carcinomas are not frequently reported. The diagnosis is often made as a result of incidental intraoperative discovery of a gallbladder mass during surgical treatment of extrahepatic cholangiocarcinoma. We experienced a case of synchronous double primary cancer of the gallbladder and distal common bile duct confirmed by pathologic evaluation, and report the case with a review of the clinical literature.
Biliary Tract* ; Cholangiocarcinoma ; Common Bile Duct ; Diagnosis ; Gallbladder ; Gallbladder Neoplasms

Twenty cases of polypoid lesions of the gallbladder were reviewed. Seven were benign lesions. Among them, there were 4 (20%) adenomas and 3 (15%) adenomatous hyperplasias. All of the benign lesions were less than 1 cm in diameter. Thirteen cases involved a carcinoma of the gallbladder, of which 92% were more than 1 cm in diameter, 76.9% were over 60 years of age, and 38.5% were associated with gallstones. The accuracy of the preoperative ultrasonographic diagnosis of the polypoid lesions of the gallbladder was 80%. The spread and the size of the tumor showed a close correlation. Therefore, the size of the tumor is a vital indicator for the treatment of polypoid lesions of the gallbladder; lesions between 0.6~1 cm in diameter should be followed up by ultrasonography. An operation may be considered if stones are present. Lesions bigger than 1 cm should be resected since malignancy can not be excluded.
Adenoma ; Diagnosis ; Gallbladder Neoplasms ; Gallbladder* ; Gallstones ; Hyperplasia ; Polyps ; Ultrasonography

Xanthogranulomatous cholecystitis is an uncommon destructive inflammatory disease with accumulation of lipid-laden macrophages, fibrous tissue, and inflammatory cells. It is often mistaken for gallbladder cancer due to diffuse wall thickening of gallbladder and infiltration into neighboring organs. And it is usually difficult to distinguish xanthogranulomatous cholecystitis from gallbladder cancer based on clinical, radiographic, or laboratory testing. Patients with xanthogranulomatous cholecystitis often undergo cholecystectomy to confirm the diagnosis, and to exclude gallbladder cancers. We report a case of 69-year-old woman with xanthogranulomatous cholecystitis who had been treated with steroid and avoided extended resection.
Aged ; Cholecystectomy ; Cholecystitis* ; Diagnosis ; Female ; Gallbladder ; Gallbladder Neoplasms ; Humans ; Macrophages

BACKGROUND/AIMS: The early diagnosis of possible cancer in thickened gallbladder wall is very important. This study was aimed to confirm the usefulness of endoscopic ultrasonography in differential diagnosis of gallbladder cancer in thickened gallbladder wall, and to find out the findings of endoscopic ultrasonography which favor malignancy. METHODS: We reviewed 67 cases of patients who underwent cholecystectomies and who also showed thickened gallbladder wall in their preoperative endoscopic ultrasonography. According to the post-surgical pathologic diagnosis, the cases were classified into malignant and benign diseases, and they were statistically compared with several findings of endoscopic ultrasonography of thickened gallbladder wall. RESULTS: Pathologic diagnosis included 10 cancers and 57 benign diseases. The sensitivity (90%) and specificity (98%) of endoscopic ultrasonography for diagnosis of gallbladder cancer were superior to those of other techniques. Wall thickness, associations of gallstones, loss or preservation of layered structure and irregularity of inner surface of thickened wall were significant variables in the differential diagnosis between malignant and benign causes of thickened gallbladder wall (p<0.05). CONCLUSIONS: Endoscopic ultrasonography is useful to diagnose gallbladder cancer within thickened wall. Loss of layered structure and irregular inner surface of thickened wall are independent predictive factor of gallbladder cancer.
Cholecystectomy ; Diagnosis ; Diagnosis, Differential ; Early Diagnosis ; Endosonography ; Gallbladder Neoplasms ; Gallbladder* ; Gallstones ; Humans ; Sensitivity and Specificity

No abstract available.
Bronchogenic Cyst/*diagnosis ; Gallbladder Neoplasms/*diagnosis ; Humans ; Korea

No abstract available.
Bronchogenic Cyst/*diagnosis ; Gallbladder Neoplasms/*diagnosis ; Humans ; Korea

Lymphangiomas are malformations of the lymphatic system, which is a common disease in children, usually superficial in body, but seldom seen in visceral organs. We present the case of a child with lymphangioma of the gallbladder. Also we reviewed the literatures. A 2-year-6-month-old boy complained of progressing difficulty in walking for 6 months. Cerebral MRI showed abnormal signals in the white matter suggesting leukodystrophy. Ultrasound of abdomen showed a mixed-echoic mass in the site of gallbladder. CT scan showed an enlarged gallbladder with increased density. Bloodcounting, liver function, and alpha fetal protein were within normal range. Exploratory laparotomy was done in order to rule out malignancy. The liver was found normal at surgery, and the gallbladder looked enlarged and deformed. The gallbladder wall was thick and edematous, and adherent with liver. The gallbladder was excised. Pathological examination gave the diagnosis as lymphangioma of the gallbladder wall. The postoperative recovery was uneventful. There was no evidence of recurrence. Searching in literatures, three cases of lymphangioma of gallbladder in adults were found. According to the pathology of lymphangioma and the anatomy of gallbladder, the outcome of this disease should be benign and may be symptomless throughout the life. No death was reported due to lymphangioma of gall bladder, nor severe complications endangering life at any age. The only indication for surgery in the reported cases was to rule out the risk of being malignancy. If MRI or other means can make a definite preoperative diagnosis of lymphangioma, being a stable lesion, surgery would be unnecessary unless there is a progressive organic obstruction causing repeated infection or persistent abdominal pain.
Child, Preschool ; Gallbladder Neoplasms ; diagnosis ; Humans ; Lymphangioma ; diagnosis ; Male

The combined diagnostic modalities using abdominal ultrasound, endoscopic ultrasound and endascopic retrograde cholangiopancreatogram are useful for the diagnosis of gall bladder disease. But, these diagnostic methods have limitations for the detection of early flat-type gallbladder cancer. To cope with these problems, double contrast study of gallbladder disease is being recently used to diagnose the flat-type cancer of gallbladder in Japan. Herein we report a case of chronic cholecystitis confirmed histologically and assisted by double contrast method of gallbladder, which was diagnosed as a gallbladder polyp by abdominal sonogram at first. The method requires the cystic duct cannulation and placement of the catheter to the gallbladder. And then Barium sulfate and CO2 are injected through the catheter. The patient didnt experience any complication during and after this procedure except for hyperamylasemia. After the simple cholecystectomy, he improved completely. In conclusion, double contrast study of gallbladder can be useful in the diagnosis of the gallbladder disease and compensate for the other dignostic tools.
Barium Sulfate ; Catheterization ; Catheters ; Cholecystectomy ; Cholecystitis* ; Cystic Duct ; Diagnosis ; Gallbladder Diseases ; Gallbladder Neoplasms ; Gallbladder* ; Humans ; Hyperamylasemia ; Japan ; Polyps ; Ultrasonography

With the developement of the conventional abdominal ultrasound, many asymptomatic gallbladder diseases are noted. The combined diagnostic modalities using abdominal ultrasound, endoscopic ultrasound and endoscopic retrograde cholangiopanereatography are useful for the diagnosis of gallbladder diseases, especially polypoid lesions. But, diagnostic accuracy or ability is not satisfactory for the detection of early gallbladder cancer, among which there are increasing trends of flat or superficial type. Many efforts were tried to diagnose these lesions through the variable methods by direct access to the gallbladder, such as percutaneous transhepatic cholecystoscopy(PTCCS). With the advent of cystic duct cannulation method, endoscopic cholecystoduodenal stenting or nasocholecystic drainage come to be available for the treatment of acute suppurative cholecystitis. Via this route, double contrast study with barium sulfate and CO2 showed fine reticular mucosal structures of the gallbladder and increased diagnostic accuracy af the flat type cancer. We report 2 cases of gallbladder diseases with early cancer confined to the mucosa and adenomyomatous hyperplasia. They were diagnosed by the double contrast method of gallbladder that was firstly introduced domestically by us after endoscopic cannulation of cystic duct and pla~eement of the catheter to the gallbladder.
Barium Sulfate ; Catheterization ; Catheters ; Cholecystitis ; Cystic Duct ; Diagnosis ; Drainage ; Gallbladder Diseases* ; Gallbladder Neoplasms ; Gallbladder* ; Hyperplasia ; Mucous Membrane ; Stents ; Ultrasonography