Ultrasound-guided fine-needle aspiration cytology diagnosis of gallbladder lesions: A study of 82 cases

Abstract

Carcinoma of the gallbladder (GB) is among the five most common forms of cancers and tops the list of gastrointestinal malignancies in females of the Delhi region. Lack of specific signs and symptoms prevents early detection of GB carcinoma. However, in recent years ultrasonographically (US)‐guided fine‐needle aspiration (FNA) cytology has been found to be a reliable procedure for its diagnosis. The present study was carried out during a period of 5 yr (1986–1990) in 64 female and 18 male patients to find out the diagnostic utility of US‐guided FNA cytology in gallbladder lesions. Ultrasonography in these 82 cases revealed a mass in the gallbladder/GB area in 74 (90.2%), a mass in the GB/pancreas in 1 (1.2%), gallstones in 32 (39.0%), and miscellaneous gallbladder lesions in 4 (4.9%). The other findings included space‐occupying lesions in liver in 18 (22.0%), portal lymphadenopathy in 12 (14.6%), and infiltration in other organs in 7 (8.5%). The initial cytodiagnosis was malignancy in 48 cases, inflammatory in 12, and inadequate in 22. Following review of the smears by one of the investigators (D.K.D.), the number of malignant cases remained 48 (58.5%). There were 10 (12.2%) inflammatory and 24 (29.3%) inadequate cases. Adenocarcinoma was the most common malignancy (83.3%), followed by squamous‐cell and adenosquamous carcinoma (12.5%) and small round cell tumors (4.2%). The 10 inflammatory lesions showed slight (+) to excessive (+++) neutrophilic infiltration and included one case each of xanthogranulomatous cholecystitis and a necrotizing granulomatous lesion likely to be of tuberculous etiology. Diagn. Cytopathol. 1998; 18:258–264. © 1998 Wiley‐Liss, Inc.

Cytologic diagnosis of gallbladder lesions — A study of 150 cases

“…This has been documented in the present series also as the male to female ratio was 1:3.4 and median age was 52 years. A few of the Indian studies have reported that carcinoma of the GB is more common in north Indian population [1,11].…”

“…The sonographic differentiation between benign inflammatory lesion and neoplastic lesion is not always reliable [17]. In a study of 82 cases by Das et al [1], 55 (67.9%) cases were considered malignant by combined clinical and imaging modalities. Out of these 40 (83.3%) were diagnosed malignant on cytology.…”

“…Though sonography helps in diagnosis of GB carcinoma in majority of the cases, yet the inflammatory changes present in it can simulate or mask the signs of malignancy [1]. The association of inflammatory diseases and carcinoma is important because there is a possibility of overlooking the carcinoma in such cases.…”

“…Gallbladder (GB) carcinoma is among the five most common forms of gastrointestinal cancers worldwide [1] and it shows marked geographic and ethnic variation [2][3][4]. In European countries and the United States of America the incidence of GB carcinoma is rare [5].…”

“…Owing to higher accuracy, beinginexpensive and ready availability, FNA of abdominal organs like liver, gastrointestinal tract and retroperitoneal lymph nodes is widely used as a diagnostic tool [7][8][9][10]. However, reports on FNA of the GB are limited [1,[11][12][13][14].…”