Handa Uma, Nanda Annu, Mohan Harsh, Kochhar Suman, Sachdev Atul
Department of Pathology, Government Medical College and Hospital, Sector 32-A, Chandigarh, 160030 India.
Indian J Surg. 2010 Jun;72(3):181-4. doi: 10.1007/s12262-010-0047-y. Epub 2010 Aug 26.
Gallbladder (GB) carcinoma is among the five most common forms of gastrointestinal cancers and the diagnosis is usually made when the carcinoma is already in an advanced stage. The aim of this study was to assess the application of ultrasound (US) guided fine needle aspiration (FNA) in diagnosing GB carcinoma.
The present study was carried out on 150 patients suspected to have GB carcinoma on ultrasonography. US-guided FNA from GB was done in these patients and FNA of the other organs was simultaneously done in 20 patients. Histopathology of the GB was available in 14 cases.
Ultrasonography in these patients revealed mass/thickening of the wall of GB in 140 (93.3%) cases and nonspecific US findings in 10 (6.7%). Out of the 140 cases malignancy was cytologically diagnosed in 105 (75%) cases while 12 (8.5%) cases were inflammatory and 23 (16.5%) were inconclusive. Adenocarcinoma was the most common morphologic type. Metastatic tumor deposits were noted in FNA from space occupying lesions of the liver in 12 cases, abdominal lymph nodes in 5 cases, and 1 case each of supraclavicular lymph node, stomach and bilateral ovaries. Of the 10 cases with non-specific US findings, 3 had carcinoma and 7 were inconclusive on cytologic examination.
US guided FNA provides a rapid and reliable diagnosis in cases of GB carcinoma.
胆囊癌是胃肠道最常见的五种癌症之一，通常在癌症已处于晚期时才得以诊断。本研究的目的是评估超声（US）引导下细针穿刺抽吸（FNA）在胆囊癌诊断中的应用。
本研究对150例超声检查怀疑患有胆囊癌的患者进行。对这些患者进行了超声引导下胆囊细针穿刺抽吸，同时对20例患者的其他器官进行了细针穿刺抽吸。14例患者获得了胆囊组织病理学检查结果。
这些患者的超声检查显示，140例（93.3%）胆囊壁有肿块/增厚，10例（6.7%）有非特异性超声表现。在140例病例中，105例（75%）经细胞学诊断为恶性，12例（8.5%）为炎症性，23例（16.5%）结果不明确。腺癌是最常见的形态学类型。在12例肝脏占位性病变、5例腹部淋巴结、1例锁骨上淋巴结、1例胃和1例双侧卵巢的细针穿刺抽吸中发现了转移瘤沉积物。在10例有非特异性超声表现的病例中，3例为癌症，7例细胞学检查结果不明确。
超声引导下细针穿刺抽吸可为胆囊癌病例提供快速可靠的诊断。
