Spectrum of gallbladder malignancies on fine‐needle aspiration cytology: 5 years retrospective single institutional study with emphasis on uncommon variants

Kumar, Rajesh; Srinivasan, Radhika; Gupta, Nalini; Dey, Pranab; Rajwanshi, Arvind; Nijhawan, Raje; Lal, Anupam; Kalra, Naveen

doi:10.1002/dc.23636

Cited by 17 publications

(12 citation statements)

References 11 publications

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“…Due to the femalepredilection nature of gallbladder carcinoma, the female gender accounts for an overwhelming proportion in these tumours. 16 The patients included in our study appeared to have large tumours and presented with an advanced SEER stage. The squamous cell component of GBC has been reported to have a doubling proliferation capacity as compared with the glandular component (doubling time of 81 days versus doubling time of 166 days).…”

Section: Discussionmentioning

confidence: 95%

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Characteristics and survival prognosis of patients with pure squamous cell carcinoma of the gallbladder

Zhu

Sun

Wei

et al. 2020

ANZ Journal of Surgery

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Background: Pure squamous cell carcinoma (SCC) of the gallbladder is rare and often confused with the adenosquamous carcinoma (ASC) subtype in previous studies. The present study was attempted to differentiate SCC from ASC by resolving their characteristics and prognosis. Methods: The Surveillance, Epidemiology, and End Results database was queried for SCC and ASC of gallbladder cases from 1988 to 2015. Patients' clinicopathological characteristics and survival were analysed between the groups. Results: Of the 709 patients with primary gallbladder cancer included in this study, 249 (35.1%) had pure SCC and the remaining 460 (64.9%) had ASC. It was found that pure SCC was associated with a larger median tumour size (58.0 versus 41.0 mm, P < 0.001), while ASC presented with a worse histological grade (47.4% versus 37.8% for grades III-IV, P = 0.019) and more lymph node invasion (27.4% versus 18.9%, P = 0.041). The 3-year overall survival and disease-specific survival rates in pure SCC were lower than those in ASC (7.5% versus 11.5% for overall survival, P < 0.001; 6.2% versus 10.9% for disease-specific survival, P < 0.001). Multivariate analysis showed that early Surveillance, Epidemiology, and End Results historic stage, treatment with surgery and chemotherapy were significant favourable prognostic factors for pure SCC, while tumour size, late study period, treatment with surgery and radiotherapy were significant predictors for ASC. Conclusion: There were significant differences in the clinicopathological characteristics and survival prognosis between pure SCC and ASC. Surgery combined with chemotherapy is the preferred treatment option for pure SCC.

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Section: Discussionmentioning

confidence: 95%

“…Biologically, both of them are highly malignant, with only 7.5% and 11.6% of 3‐year survival rate, respectively. Due to the female‐predilection nature of gallbladder carcinoma, the female gender accounts for an overwhelming proportion in these tumours 16 …”

Section: Discussionmentioning

confidence: 99%

Characteristics and survival prognosis of patients with pure squamous cell carcinoma of the gallbladder

Zhu

Sun

Wei

et al. 2020

ANZ Journal of Surgery

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“…6 Venkataramu et al in 2010 found 89.7 %, and Kumar et al 2017 found 96% of adenocarcinoma in their study of GB masses. 3,11 Cholelithiasis is a common association of GB malignancy. Gall stone causes chronic irritation of the GB wall which leads to production of secondary bile acids.…”

Section: Figure 7: (A) Usg Showing Gallbladder Wall Thickening At Funmentioning

confidence: 99%

Ultrasound guided fine needle aspiration cytology of gall bladder mass and mural thickening: a radio-pathological correlation

Barman¹,

Bujarbaruah²,

Choudhury³

et al. 2019

Int J Res Med Sci

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Background: Carcinoma of the gall bladder (GB) is the commonest malignancy of the biliary tract. Ultrasound (US) guided Fine Needle Aspiration Cytology (FNAC) plays a major role in early detection of malignancy in a suspicious GB lesion. The aim of this study was to evaluate the safety and diagnostic accuracy of US guided FNAC in detection of GB malignancy, to find the association of gall stones with GB malignancy, to study the ultrasound pattern of GB malignant mass and demographic profile of the disease in North eastern India.Methods: The study was conducted retrospectively in Dr. B. Borooah Cancer Institute, Guwahati from January 2016 to December 2017. A total number of 173 patients suspected to have GB malignancy were subjected to US guided FNAC.Results: Total 161 patients were positive for malignancy with significant female majority. There were 124 female (77.02%) and 37 males (22.98%) in the range of 29 to 82 years. Male female ratio was 1:3.5. One was diagnosed as xanthogranulomatous cholecystitis and another was chronic cholecystitis. FNAC remained inconclusive in 2 patients. There was no major procedure related complication. Adenocarcinoma was the most common malignancy found in 146 patients (98.68%). Cholelithiasis was associated in 88.19% of malignant lesions.Conclusions: US-guided FNAC is a safe, highly accurate and reliable procedure for early detection of GB malignancy.

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“…Because of extremely poor prognosis and limited treatment options and survival, pathological diagnosis is necessary to rule out potentially treatable alternate pathologies, and to counsel the patient and family. Available sampling techniques are ultrasound (USG) 22 23 24 25 , and computed tomography (CT)-guided cytology/biopsy, ERCP brushing and biopsy and EUS-FNA/EUS-fine needle biopsy (EUS-FNB). US-guided sampling is one of the most common modalities, with sensitivity more than 88 % but it may be associated with bile leak and pain 22 24 , and small mass lesions presenting with jaundice may not be visualized with it.…”

Section: Discussionmentioning

confidence: 99%

Role of EUS-FNA for gallbladder mass lesions with biliary obstruction: a large single-center experience

et al. 2019

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Background and study aims Although endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) is an established modality for pathological sampling of pancreatic and biliary lesions, limited data are available on the diagnostic value of EUS-FNA for evaluation of gallbladder mass lesions, a common cause of obstructive jaundice. We aimed to evaluate the usefulness of EUS-FNA for diagnosis of gallbladder mass lesions presenting with biliary obstruction. Patients and methods This study was a retrospective analysis of data from patients who had undergone EUS-FNA for gallbladder mass lesions. FNA was performed on either a gallbladder mass, metastatic node or liver lesions. Outcome measures were diagnostic yield of EUS FNA and adverse events. Results From April 2011 to August 2018, 101 patients with gallbladder mass lesions with biliary obstruction underwent EUS-FNA. The final diagnosis was malignancy in 98, benign disease in one, and two patients were lost to follow-up. EUS-FNA confirmed the diagnosis in 89 of 98 patients with malignancy (sensitivity 90.81 %); was false negative in nine of 98 cases with malignancy; and was truly negative in the solitary patient with benign disease (specificity 100 %). Positive predictive value, negative predictive value (NPV), and accuracy were 100 %, 10 %, and 90.90 %, respectively. Two patients had self-limiting pain. Conclusion EUS-FNA is a sensitive tool for evaluation of gallbladder mass lesions presenting with obstructive jaundice. However, because of low NPV, lesions in which FNA is negative should be further evaluated.

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Spectrum of gallbladder malignancies on fine‐needle aspiration cytology: 5 years retrospective single institutional study with emphasis on uncommon variants

Abstract: Adenocarcinoma is most common type of gallbladder malignancy; however, other unusual types of carcinomas occur and in such cases, FNAC supplemented by cell block immunocytochemistry is required for an accurate diagnosis. Diagn. Cytopathol. 2017;45:36-42. © 2016 Wiley Periodicals, Inc.

Cited by 17 publications

References 11 publications

Characteristics and survival prognosis of patients with pure squamous cell carcinoma of the gallbladder

Characteristics and survival prognosis of patients with pure squamous cell carcinoma of the gallbladder

Ultrasound guided fine needle aspiration cytology of gall bladder mass and mural thickening: a radio-pathological correlation

Role of EUS-FNA for gallbladder mass lesions with biliary obstruction: a large single-center experience

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