​Pathology - Gallbladder Tumor and Biliary Duct Tumor

​Pathology - Gallbladder Tumor and Biliary Duct Tumor 
Gallbladder adenocarcinoma (AGB): Linked to gallstones; the most prevalent primary tumor of the gallbladder; typically occurs in women over the age of 60.
Extrahepatic biliary ducts (EBD) and ampulla of Vater carcinoma: Uncommon: linked to Clonorchis sinensis infection and primary sclerosing cholangitis. Typically occurs in older males.
Terms and conditions: Gross examination reveals a growth pattern characterized by widespread thickening of the gallbladder wall. An exophytic pattern is observed, with irregular cauliflower-like masses growing into the lumen. Adenocarcinoma at a microscopic level showing varied levels of differentiation and commonly infiltrating the liver.
EBD: Appearance: tiny gray nodules located in the wall of the bile duct. Microscopic findings include adenocarcinoma with mucin-secreting cells, fibrous stroma, and epithelial proliferation.
AGB: Initial symptoms are gradual and similar to those of gallstones, including stomach pain, jaundice, loss of appetite, and nausea with vomiting.
The patient with EBD displays symptoms such as worsening obstructive jaundice, nausea, vomiting, weight loss, and an enlarged gallbladder that can be felt, which is not typical of gallstone disease.
Laboratory results for both types: High liver function tests and prolonged prothrombin time.

Treatment: Cholecystectomy, chemotherapy, radiation for AGB.
Ductal malignancies  (EBD) cannot be removed with surgery and are managed with chemotherapy and/or radiotherapy, while ampullary cancers are typically surgically removed.

Bile Duct Tumor