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[Morphological analysis of the gallbladder elevated lesions--Macroscopic, stereoscopic, and histological study]
11st Department of Surgery, Tokyo Medical and Dental University, School of Medicine.
Abstract:
I analyzed morphological pathology of elevated lesions of gallbladder (ELGB) 136 cases, 177 lesions. According to the characteristic morphological feature, I can reach to differential diagnosis of ELGB. Most of I s and II a type carcinoma is papillary adenocarcinoma, which have irregular papillary surface. A few of II a type carcinoma is tubular adenocarcinoma, which is macroscopically granular and nodular, but, have stereoscopically small, uneven pits. Adenoma, most of which is tubular adenoma, is pedunculated, and have macroscopically multinodular, stereoscopically smooth surface. Whereas, hyperplastic polyp can be classified to "papillary type" and "nodular type", according to surface structure. "Papillary type" is pedunculated or sessile, but, "nodular type" is only sessile. This morphological feature is different from adenoma's. Pedunculated carcinoma (I p type) is frequently localized in mucosa. Whereas, if we can exclude adenomyomatosis, sessile lesion, more than 13mm is frequently advanced carcinoma, which invade to subserosa or more deeply. But, sessile carcinoma, smaller than 11mm, is frequently early carcinoma, which is localized in mucosa or muscle layer.