1/42. A case of primary adenosquamous/squamous cell carcinoma of gallbladder directly invaded duodenum.A rare case of primary gallbladder carcinoma is reported. A 67 year-old woman was admitted to our hospital for treatment of suspected duodenal carcinoma. A series of radiographic examinations demonstrated a giant tumor involving the duodenum, gallbladder, pancreatic head, and transverse colon. These extensions made it difficult to identify the primary origin of the carcinoma. Pancreatoduodenectomy, cholecystectomy, and resection of the transverse colon were performed. Macroscopically, ulcerative lesions were seen in both the gallbladder and the duodenum. Microscopic examination revealed adenosquamous cell carcinoma of the gallbladder, invasive of the adjacent organs, including circumferential invasion of the second portion of the duodenum. The patient tolerated the operation well and was discharged 28 days post-operatively, but died of liver metastasis 4 months after surgery. Local invasion of the surrounding tissues is characteristic of adenosquamous/squamous cell carcinoma of the gallbladder. Although surgery for cure is deemed possible, the rapid growth rate of this type of tumor may cast doubt on the value of extensive radical surgery.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/42. The role of lymphatic drainage of the liver in gallbladder cancer: a case report.We report a case of a patient with a unique lymph node relapse after right hepatectomy and aggressive lymph node dissection for gallbladder cancer. There was extensive involvement of the hepatic parenchyma from the primary tumor, but no extension to the lymph nodes or other adjacent organs. Seventeen months later, the patient underwent re-dissection of the retroperitoneal lymph nodes with right nephrectomy and partial resection of the vena cava because of lymph node recurrence at the hilum of the right kidney. This pattern of lymph node metastasis to the right side of the vena cava from gallbladder cancer invading the liver is probably due to the distinct lymphatic drainage of the liver.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
3/42. An effective pre-operative chemoimmunotherapy regimen against advanced gallbladder carcinoma: a case report.We designed a chemoimmunotherapy regimen with a single dose of mitomycin C (MMC) followed by subsequent OK-432 injections, since the ability of peripheral blood mononuclear cells (PBM) to generate OK-432 activated killer cells had previously been shown to be augmented by MMC in cancer patients. We herein report on a case with far advanced gallbladder carcinoma who demonstrated a remarkable response to this chemoimmunotherapy, and thus underwent a curative resection. A 67 year-old Japanese woman was diagnosed as having gallbladder carcinoma with invasion to the liver and portal vein, as well as obvious lymph node metastasis. Since these findings suggested the tumor to be unresectable at that time, our chemoimmunotherapy regimen with MMC and OK-432 was administered. After four courses of therapy, a computed tomography (CT) scan revealed the disappearance of both tumor invasion to the surrounding organs and lymph node metastasis, which therefore prompted us to attempt a radical tumor resection. The histology of the resected specimen revealed that the majority of cancer cells had been killed by the pre-operative therapy and that only remnants of viable cancer cells were found in a part of the neck of the gallbladder and in 2 regional lymph nodes. This experience thus suggests the effectiveness of our chemoimmunotherapy regimen against gallbladder carcinoma.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
4/42. Low-grade B cell lymphoma of mucosa-associated lymphoid tissue (MALT) arising in the gallbladder.Mucosa-associated lymphoid tissue (MALT) lymphomas arise in most cases in the gastrointestinal tract, and are usually of low-grade B cell origin. MALT lymphomas may rarely occur in organs where lymphoid tissue is sparse, especially following inflammatory conditions. Primary lymphomas of the gallbladder are extremely rare, and MALT lymphoma has been reported only twice. We herein describe the third case of low-grade MALT lymphoma of the gallbladder, which exhibits an unusual clinical behavior. The exceptionally advanced stage of the disease stresses the importance of early operation when cholecystectomy is indicated.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
5/42. Pyloric gland metaplasia with perineural invasion of the gallbladder: A lesion that can be confused with adenocarcinoma.BACKGROUND: Metaplastic pyloric glands have been described in a variety of organs including the gallbladder, in which they can extend into the muscular wall and serosa. methods: Clinical, histologic, and immunohistochemical features of four cases of gallbladder florid pyloric gland metaplasia with perineural and intraneural invasion are analyzed. RESULTS: The patients with pyloric gland metaplasia and perineural and intraneural invasion were all females ages 57-72 years. A preoperative diagnosis of chronic cholecystitis and cholelithiasis was made for all four patients, but a histologic diagnosis of adenocarcinoma was made for two patients and entertained in two others. Macroscopically the gallbladders showed changes usually associated with chronic cholecystitis. No intraluminal masses were observed in any of the gallbladders. The characteristic microscopic features included florid pyloric gland metaplasia, proliferation of medium-sized nerve trunks more prominent in the muscular layer and serosa, and perineural and intraneural invasion by the metaplastic glands lined by cytologically bland cuboidal or columnar mucin-containing cells. At last follow-up all patients were alive and symptom free 1-7 years after laparoscopic cholecystectomy. CONCLUSIONS: Pyloric gland metaplasia of the gallbladder should be added to the long and increasing list of benign epithelial proliferations that are associated with perineural and intraneural invasion. This lesion should not be mistaken for adenocarcinoma of the gallbladder, a misinterpretation that may have serious therapeutic implications. The pathogenesis of this phenomenon is unknown.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
6/42. Large cell neuroendocrine carcinoma of the gallbladder: report of two cases.We report two cases of primary large cell neuroendocrine carcinoma (LCNEC) of the gallbladder, which, to the best of our knowledge, represent the first description of this entity. One of the tumors consisted entirely of LCNEC, whereas the second tumor was composed of LCNEC and the more common intestinal-type adenocarcinoma. Both tumors were morphologically similar to their pulmonary counterpart and were characterized by large cells with prominent nucleoli, coarse chromatin, and a high mitotic rate. The cells showed an organoid growth pattern with rosette formation and frequent areas of necrosis. Panendocrine markers were expressed in a variable proportion of tumor cells in both cases, and one of the cases also showed focal positivity for type 2 somatostatin receptors. One of the tumors followed a rapidly fatal course despite aggressive surgical treatment and chemotherapy administration, and the second patient is still alive and disease-free 12 months after surgery. The description of these two cases of LCNEC of the gallbladder is significant for two reasons. From an academic standpoint, we now know that all the neuroendocrine tumors described in other organs can arise de novo in the gallbladder. More importantly, however, the recognition of this rare tumor type carries important clinical implications in regard to the use of chemotherapeutic agents and supplemental treatments (for example, somatostatin analogs).- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
7/42. Primary low-grade MALT lymphoma of the gallbladder.We report a case of primary low-grade B-cell lymphoma of the mucosa-associated lymphoid tissue (low-grade MALT lymphoma) in the gallbladder. A 58-year-old woman suspected of gallbladder carcinoma underwent laparoscopic cholecystectomy. Microscopic examination of the gallbladder demonstrated lymphoid cell infiltration forming lymphoid follicles with hyperplastic secondary follicles. The surrounding monocytoid B cells and centrocyte-like cells selectively infiltrated the crypt epithelium forming lympho-epithelial lesions. plasma cells were also noted beneath the mucosal epithelium. bile culture revealed the Gram-negative bacilli enterococcus faecalis and morganella morganii. Immunoglobulin heavy chain gene rearrangement was confirmed using polymerase chain reaction (PCR) and oligoclonal lymphoid proliferations was detected. Because autoimmune diseases, or chronic inflammatory disorders, seem to correlate with the occurrence of MALT lymphoma, Gram-negative bacterial infection could also be considered as a prodrome of MALT lymphoma of the gallbladder.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
8/42. Gingival metastasis from gallbladder cancer.gallbladder cancer is generally diagnosed at an advanced stage. The liver is the most commonly invaded organ by direct extension and/or metastasis, followed by regional lymph nodes. Oral soft tissue metastasis is extremely unusual. This report describes the case of a 62-year-old woman diagnosed with advanced metastatic gallbladder cancer, who initially presented with abdominal pain. diagnosis of gallbladder cancer was made about 3 months after her symptoms developed, when a laparoscopic cholecystectomy was performed because of the suspicion of gallstones. liver metastasis was also discovered during surgery. A postoperative investigation revealed additional lung and bone metastases. A visible left gingival tumor was found on physical examination and was confirmed as gallbladder cancer metastasis by compatible histopathology 1 month after surgery. The patient responded poorly to chemotherapy and unfortunately died 5 months after the diagnosis. The clinical presentation of gallbladder cancer was relatively typical, apart from the unusual gingival metastasis. The medical literature contains quite a few examples of metastatic lesions located strictly in the oral soft tissue, however no case of gallbladder cancer metastasizing to the oral soft tissue has been previously reported.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
9/42. Malignant melanoma of the gallbladder: report of three cases and review of the literature.Three cases of primary melanoma of the gallbladder are described to add to the five reported in the literature. As an organ of endodermal origin, the gallbladder appears to share the melanoblastic potentiality possessed by similarly derived organs, and hence, the development of a melanoma within the gallbladder is not unexpected. Presence of melanocytes within the gallbladder mucosa is absolute proof that the tumor is primary. Whether these cells originate from the neural crest and migrate to the gallbladder, or result from local differentiation from preexisting cells remains to be answered.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
10/42. Metastatic renal cell carcinoma of the gallbladder.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. gallbladder metastasis in this case was detected clinically.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
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