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Gallbladder Carcinoma: Radiologic-Pathologic Correlation¹

¹ From the Departments of Radiologic Pathology (A.D.L., C.A.R.), and Hepatic and Gastrointestinal Pathology (L.A.M.), Armed Forces Institute of Pathology, 6825 16th St NW, Bldg 54, Rm M-121, Washington, DC 20306-6000; the Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (A.D.L.); and the Department of Radiology, University of Washington, Seattle (C.A.R.). Received; revision requested; revision received; accepted. Address correspondence to A.D.L. (e-mail: levya@afip.osd.mil).

Primary carcinoma of the gallbladder is an uncommon, aggressive malignancy that affects women more frequently than men. Older age groups are most often affected, and coexisting gallstones are present in the vast majority of cases. The symptoms at presentation are vague and are most often related to adjacent organ invasion. Therefore, despite advances in cross-sectional imaging, early-stage tumors are not often encountered. Imaging studies may reveal a mass replacing the normal gallbladder, diffuse or focal thickening of the gallbladder wall, or a polypoid mass within the gallbladder lumen. Adjacent organ invasion, most commonly involving the liver, is typically present at diagnosis, as is biliary obstruction. Periportal and peripancreatic lymphadenopathy, hematogenous metastases, and peritoneal metastases may also be seen. The vast majority of gallbladder carcinomas are adenocarcinomas. Because most patients present with advanced disease, the prognosis is poor, with a reported 5-year survival rate of less than 5% in most large series. The radiologic differential diagnosis includes the more frequently encountered inflammatory conditions of the gallbladder, xanthogranulomatous cholecystitis, adenomyomatosis, other hepatobiliary malignancies, and metastatic disease.

Index Terms: Gallbladder, neoplasms, 762.321

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