Das D K, Tripathi R P, Bhambhani S, Chachra K L, Sodhani P, Malhotra V
Institute of Cytology and Preventive Oncology, New Delhi, India.
Diagn Cytopathol. 1998 Apr;18(4):258-64. doi: 10.1002/(sici)1097-0339(199804)18:4<258::aid-dc2>3.0.co;2-8.
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 (+3) neutrophilic infiltration and included one case each of xanthogranulomatous cholecystitis and a necrotizing granulomatous lesion likely to be of tuberculous etiology.
胆囊癌是最常见的五种癌症之一，在德里地区女性胃肠道恶性肿瘤中位居榜首。缺乏特异性体征和症状使得胆囊癌难以早期发现。然而，近年来，超声引导下细针穿刺（FNA）细胞学检查已被证明是一种可靠的诊断方法。本研究在5年期间（1986 - 1990年）对64例女性和18例男性患者进行，以探讨超声引导下FNA细胞学检查在胆囊病变中的诊断价值。这82例患者的超声检查显示，74例（90.2%）胆囊/胆囊区域有肿块，1例（1.2%）胆囊/胰腺有肿块，32例（39.0%）有胆结石，4例（4.9%）有其他胆囊病变。其他发现包括18例（22.0%）肝脏占位性病变，12例（14.6%）门静脉淋巴结肿大，7例（8.5%）其他器官浸润。最初的细胞诊断为恶性48例，炎症12例，不充分22例。经一名研究者（D.K.D.）复查涂片后，恶性病例数仍为48例（58.5%）。炎症病例10例（12.2%），不充分病例24例（29.3%）。腺癌是最常见的恶性肿瘤（83.3%），其次是鳞状细胞癌和腺鳞癌（12.5%）以及小圆形细胞瘤（4.2%）。10例炎症性病变显示轻度（+）至重度（+3）中性粒细胞浸润，包括1例黄色肉芽肿性胆囊炎和1例可能为结核病因的坏死性肉芽肿性病变。
