Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Surgical Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abdom Radiol (NY). 2024 Mar;49(3):703-709. doi: 10.1007/s00261-023-04090-x. Epub 2023 Nov 16.
To describe the radiopathological characteristics of a new morphological "combined type" of gallbladder cancer (GBC) and compare it with the mass replacing gallbladder and thickening types of GBC.
The imaging and pathological details of consecutive patients with GBC between August 2020 and December 2022 were retrospectively reviewed. Two radiologists reviewed computed tomography/magnetic resonance imaging in consensus for the morphological type of GBC. The radiologists classified GBC as mass replacing gallbladder, wall thickening, and combined type. The combined type was defined as a mass arising from the thickened wall of an adequately distended gallbladder that extended exophytically into the adjacent liver parenchyma. The presence of calculi, site, and size of lesion, biliary/portal vein involvement, liver, lymph node, and omental metastases was compared among the various types. The pathological characteristics were also compared.
Of the 481 patients (median age 55 years, 63.2% females) included in the study, mass replacing gallbladder, wall thickening, and combined-type GBC were seen in 42.8% (206/481), 40.5% (195/481), and 16.6% (80/481) of patients, respectively. In the combined type of GBC, biliary/portal vein involvement was seen in 63.7% (51/80) and 7.5% (6/80) of patients. Liver, lymph node, and omental metastases were seen in 67.5% (54/80), 40% (32/80), and 41.2% (33/80) patients, respectively. Liver metastases were significantly more common in the combined type (p = 0.002). There were no significant differences in pathological characteristics among the various types.
Combined-type GBC is less common than the mass replacing gallbladder and thickening types and is associated with a higher risk of liver metastases.
描述一种新的胆囊癌（GBC）形态“混合型”的放射病理学特征，并将其与肿块型胆囊癌和胆囊壁增厚型 GBC 进行比较。
回顾性分析 2020 年 8 月至 2022 年 12 月连续 GBC 患者的影像学和病理细节。两名放射科医生对 CT/MRI 进行了共识审查，以确定 GBC 的形态类型。放射科医生将 GBC 分为肿块型胆囊癌、胆囊壁增厚型和混合型。混合型定义为起源于充分扩张的胆囊增厚壁的肿块，向相邻肝实质外生延伸。比较各种类型中结石的存在、病变的部位和大小、胆管/门静脉受累、肝、淋巴结和网膜转移的情况。还比较了病理特征。
在 481 名患者（中位年龄 55 岁，63.2%为女性）中，肿块型胆囊癌、胆囊壁增厚型和混合型 GBC 分别占 42.8%（206/481）、40.5%（195/481）和 16.6%（80/481）。在混合型 GBC 中，胆管/门静脉受累分别见于 63.7%（51/80）和 7.5%（6/80）的患者。肝、淋巴结和网膜转移分别见于 67.5%（54/80）、40%（32/80）和 41.2%（33/80）的患者。肝转移在混合型中更为常见（p=0.002）。各种类型之间的病理特征无显著差异。
混合型 GBC 比肿块型胆囊癌和胆囊壁增厚型 GBC 少见，与更高的肝转移风险相关。
