Pitfalls in diagnosing Gallbladder Carcinoma - A Single Center Histopathology Study

Area of Science:

• Gastroenterology
• Pathology
• Oncology

Background:

• Gallbladder carcinoma is a rare malignancy, the fifth most common gastrointestinal cancer.
• Most cases lack a detectable mass on gross or radiological examination, complicating histological diagnosis.
• Histological misdiagnosis can occur due to subtle or absent tumorous masses.

Purpose of the Study:

• To identify pathological features contributing to diagnostic difficulties in gallbladder carcinoma.
• To analyze common pitfalls in the histological diagnosis of gallbladder cancer.
• To improve the accuracy of gallbladder carcinoma diagnosis.

Main Methods:

• Retrospective review of 22 gallbladder carcinoma cases (2018-2023).
• Analysis of histopathology slides, reports, and patient histories by multiple pathologists.
• Identification and documentation of diagnostic challenges and pitfalls encountered.

Main Results:

• Nine of 22 cases (41%) presented with tumor masses.
• Diagnostic challenges were noted in nine cases.
• Common pitfalls included misinterpreting Rokitansky-Aschoff sinuses and adenomyosis as carcinoma, under-sampling, and misidentifying occult disease or mucin pools.

Conclusions:

• Deeply penetrating Rokitansky-Aschoff sinuses and adenomyosis can be mistaken for gallbladder carcinoma.
• Careful examination for mural thickening and deep glandular structures is crucial.
• Accurate diagnosis requires vigilance against common histological mimics.