| Abstracts:
Gallbladder carcinoma: radiologic-pathologic
correlation. RadioGraphics 2001; 21:295 -314.
World Health Organization
classification of tumors: pathology and genetics of tumours of the
digestive system. Lyon, France: IARC, 2000; 204-217.
Tumors of the gallbladder and
extrahepatic bile ducts. Atlas of tumor pathology, fasc 22, ser 2.
Washington, DC: Armed Forces Institute of Pathology, 1986.
Protease-activating-receptor-2 is frequently expressed in papillary
adenocarcinoma of the gallbladder.
Oncol Rep. 2004
Nov;12(5):1013-6.
Gallbladder
carcinoma is one of the most devastating malignant tumors in Japan. An
important risk factor for gallbladder carcinoma is pancreaticobiliary
maljunction (PBM), which allows reciprocal reflux of bile and
pancreatic juice. Protease-activated-receptor-2 (PAR-2), which is
activated by trypsin, may be a key molecule in the process of
carcinogenesis in the gallbladder epithelium. We investigated the
relation between the expression of PAR-2 and clinicopathological
findings in gallbladder carcinoma. The study group comprised 58
patients with gallbladder carcinoma. PAR-2 expression was identified
by immunohistochemical staining of all tumor specimens. PAR-2 was
expressed in cancerous gallbladder epithelium in 37 of 58 patients
(64%). PAR-2 expression occurred more frequently in papillary
adenocarcinoma (15 of 16 patients, 94%) than in non-papillary types
(20 of 42 patients, 48%, p=0.005). Neither lymphatic invasion (p=0.03)
nor venous invasion (p=0.009) occurred more frequently in gallbladder
carcinoma with PAR-2 than in that without PAR-2. PAR-2 expression was
not directly related to PBM (p=0.46). Papillary adenocarcinoma was
associated with polypoid growth (p=0.01), PBM (p=0.01), decreased
invasion to lymphatic (p=0.007) and venous vessels (p=0.005), lower
T-factor (p<0.001), and lower clinical stage (p=0.02). PAR-2 is
frequently expressed in papillary adenocarcinoma of the gallbladder.
Trypsin may play an important role for carcinogenesis of the
gallbladder through PAR-2 signaling.
Morphological
analysis of the gallbladder elevated lesions--Macroscopic,
stereoscopic, and histological study.
Nippon Shokakibyo Gakkai Zasshi. 1995 Aug;92(8):1149-60.
I analyzed
morphological pathology of elevated lesions of gallbladder (ELGB) 136
cases, 177 lesions. According to the characteristic morphological
feature, I can reach to differential diagnosis of ELGB. Most of I s
and II a type carcinoma is papillary adenocarcinoma, which have
irregular papillary surface. A few of II a type carcinoma is tubular
adenocarcinoma, which is macroscopically granular and nodular, but,
have stereoscopically small, uneven pits. Adenoma, most of which is
tubular adenoma, is pedunculated, and have macroscopically
multinodular, stereoscopically smooth surface. Whereas, hyperplastic
polyp can be classified to "papillary type" and "nodular type",
according to surface structure. "Papillary type" is pedunculated or
sessile, but, "nodular type" is only sessile. This morphological
feature is different from adenoma's. Pedunculated carcinoma (I p type)
is frequently localized in mucosa. Whereas, if we can exclude
adenomyomatosis, sessile lesion, more than 13mm is frequently advanced
carcinoma, which invade to subserosa or more deeply. But, sessile
carcinoma, smaller than 11mm, is frequently early carcinoma, which is
localized in mucosa or muscle layer.
Pathology of
carcinoma of the gallbladder.
World J Surg. 1991 May-Jun;15(3):315-21.
A
clinicopathologic study of 40 cases of carcinoma of the gallbladder is
presented. Twenty-six cases resected were assessed retrospectively
with respect to the operative procedures employed and the results
based on the pathologic findings from the resected specimens. The
relationship between clinical features, macroscopic forms of tumor,
histological types, liver invasion, and lymph node metastasis were
investigated. Papillary, papillary infiltrative and nodular forms were
classified as either papillary adenocarcinoma or well-differentiated
tubular adenocarcinoma and invasion of the liver and lymph node
metastasis were rare. Frequent lymph node metastasis was encountered
in the nodular infiltrative form and invasion of the liver was
frequently present in the infiltrative form. Invasion of the liver,
lymph node metastasis, and the presence of gallstones were less
frequent in papillary adenocarcinoma. In contrast,
moderately-differentiated tubular adenocarcinoma frequently had lymph
node metastasis. Invasion of the liver and lymph node metastasis were,
however, present regardless of the histologic types and were more
related to the extent of subserosal involvement present. A female
preponderance was noted in poorly-differentiated adenocarcinoma. The
main reasons for surgery being limited to exploratory laparotomy only
or palliative procedures included carcinoma infiltration into the
hepatoduodenal ligament, carcinoma extension to the neighboring
structures, multiple liver metastases, peritoneal dissemination, large
liver invasion, and multiple metastases to the paraaortic lymph nodes.
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