Gb Pathology Part 3

GB perforation, also known as gallbladder perforation, is a condition where there is an actual rupture of the gallbladder wall. It is seen in about 5-10% of cases of acute cholecystitis, which is inflammation of the gallbladder. GB perforation can occur at any stage of acute cholecystitis, and it is a serious complication that can lead to the leakage of bile and infection in the abdominal cavity. Prompt medical intervention is necessary to treat GB perforation and prevent further complications.

If a localized fluid collection is seen within the GB bed, it is indicative of GB perforation. This means that there is a hole or tear in the gallbladder, causing fluid to accumulate in the surrounding area. GB perforation is a serious condition that requires immediate medical attention and can lead to complications such as infection or abscess formation. Therefore, it is important to suspect GB perforation if a localized fluid collection is observed.

The correct answer is "acute, subacute, chronic". This answer lists the three types of GB perforation: acute, subacute, and chronic.

Bouveret's syndrome is a rare condition where a gallstone moves from the gallbladder into the stomach or duodenum, causing an obstruction. This obstruction can occur when the gallstone passes through a fistula, which is an abnormal connection between the gallbladder and the gastrointestinal tract. Bouveret's syndrome is named after Leon Bouveret, a French physician who first described this condition in 1896.

In sonographic appearance of GB perforation, it is common to see an abscess adjacent to the GB with subacute involvement. This means that when the gallbladder perforates, it is often accompanied by the formation of an abscess in the surrounding area. The involvement of the abscess is usually in the subacute stage, indicating that it is not an acute or chronic condition. Therefore, the statement is true.

Chronic cholecystitis is the most common form of symptomatic gallbladder disease that is almost always associated with stones. This means that over a long period of time, inflammation of the gallbladder occurs, causing symptoms and is typically accompanied by the presence of gallstones. This is in contrast to acute cholecystitis, which is a sudden and severe inflammation of the gallbladder.

Patients with chronic cholecystitis often experience recurrent episodes of biliary colic, which is characterized by severe pain that lasts for several hours. This pain can be caused by either a transient obstruction of the gallbladder neck or by a stone blocking the cystic duct.

The "WES" triad refers to the presence of three radiological findings: Wimberger's sign, enlarged epiphyses, and skeletal survey abnormalities. These findings are commonly seen in patients with Wilson's disease, a genetic disorder characterized by impaired copper metabolism. The term "double arc shadow" is used to describe the radiological appearance of the liver in Wilson's disease, where two arcs of increased density can be seen on imaging studies. This sign is part of the "WES" triad and helps in the diagnosis of Wilson's disease.

A positive "WES" sign refers to the presence of a palpable gallbladder on physical examination. Chronic cholecystitis is a condition characterized by inflammation of the gallbladder, often due to gallstones. In this condition, the gallbladder may become enlarged and palpable, leading to a positive "WES" sign. Therefore, it is true that a positive "WES" sign may be identified with chronic cholecystitis.

A porcelain gallbladder refers to the calcification of the gallbladder wall, which is often seen in association with gallstones and chronic cholecystitis. The term "porcelain" is used to describe the appearance of the gallbladder wall, which becomes thickened and rigid due to the deposition of calcium. This condition is usually diagnosed through imaging studies such as ultrasound or CT scan. If left untreated, it can increase the risk of developing gallbladder cancer.

Having a porcelain gallbladder increases the risk of developing gallbladder cancer. Porcelain gallbladder refers to the calcification of the gallbladder wall, which can be detected through imaging tests. This condition is associated with chronic inflammation and scarring of the gallbladder, which can lead to the development of cancerous cells. Therefore, it is true that having a porcelain gallbladder increases the risk of gallbladder cancer.

Bouveret's syndrome and gallstone ileus are both conditions that involve an obstruction of the stomach or duodenum caused by a gallstone. Bouveret's syndrome specifically refers to a gallstone that has migrated through a fistula, while gallstone ileus refers to a gallstone that has passed into the small intestine and caused an obstruction. Both conditions can cause similar symptoms and require medical intervention to relieve the obstruction.

GB neoplasms can be benign or malignant. This means that growths or tumors in the GB can either be non-cancerous (benign) or cancerous (malignant). Benign neoplasms do not invade nearby tissues or spread to other parts of the body, while malignant neoplasms have the potential to invade nearby tissues and metastasize to other organs. Therefore, in the context of GB neoplasms, the opposite of benign is malignant.

An adenoma is a benign overgrowth of the epithelial cells in the gallbladder. It is the most common type of benign tumor that can develop in the gallbladder. Adenomas are typically non-cancerous and do not spread to other parts of the body. They are usually discovered incidentally during medical imaging or surgery for other conditions. While adenomas are generally harmless, they may need to be monitored or removed if they grow large or cause symptoms.

The correct answer includes two possibilities: polyp and GB polyp. Adenoma is a type of polyp that can occur in various organs, including the gallbladder (GB polyp). Therefore, when considering the differential diagnosis of adenoma, both polyp and GB polyp should be considered as potential options.

A polyp is the most common pseudo-tumor of the GB. A polyp is an abnormal growth of tissue that protrudes from the inner lining of an organ, in this case, the gallbladder. It can develop due to inflammation or other factors, and although most polyps are benign, they can sometimes become cancerous. Therefore, it is important to monitor and potentially remove gallbladder polyps to prevent any complications or progression to malignancy.

Hyperplasia of the GB epithelium refers to an abnormal increase in the number of cells in the gallbladder epithelium. This can lead to the formation of diverticulums or sinus-like structures within the gallbladder wall. These sinus formations are specifically known as Rokitansky-Aschoff sinuses, named after the pathologists Carl von Rokitansky and Ludwig Aschoff who first described them. Rokitansky-Aschoff sinuses are a characteristic feature of chronic cholecystitis, a condition characterized by inflammation of the gallbladder.

Adenomyomatosis is a condition characterized by the presence of abnormal growths in the gallbladder wall. It is often asymptomatic, meaning that patients do not experience any noticeable symptoms. Additionally, adenomyomatosis is more commonly observed in women over the age of 40. Therefore, the statement "Patients with adenomyomatosis are often asymptomatic and is usually seen in women over 40" is true.

Carcinoma is a type of cancer that originates in the epithelial tissues, which are the cells that line the body's organs and tissues. It is the most common type of cancer and accounts for about 85% of all cancer cases. However, primary GB carcinoma is rare and only makes up about 4% of all cancers. This means that while carcinoma is a common form of cancer, primary GB carcinoma specifically is a rare occurrence.

Gallbladder carcinoma refers to cancerous tumors in the gallbladder. The given statement suggests that 98% of patients with gallbladder carcinoma will also have gallstones, which are hardened deposits in the gallbladder. Additionally, 25% of these patients will have a condition called porcelain gallbladder, where the walls of the gallbladder become calcified and brittle. This answer indicates the high prevalence of gallstones and the relatively lower occurrence of porcelain gallbladder in patients with gallbladder carcinoma.

Patients with primary GB carcinoma may be asymptomatic or present with symptoms similar to cholecystitis. This is because both conditions involve inflammation of the gallbladder. Cholecystitis is characterized by symptoms such as abdominal pain, fever, nausea, and vomiting, which can also be seen in patients with primary GB carcinoma. Therefore, it can be difficult to differentiate between the two based on symptoms alone, and further diagnostic tests may be necessary to confirm the diagnosis.

Polyps in the gallbladder are growths that are attached to the inner wall of the gallbladder and do not change position. Unlike gallstones, which can move within the gallbladder, polyps remain fixed in their location. Therefore, the statement that polyps do not change position within the gallbladder is true.

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Bouveret's syndrome is a rare condition characterized by the passage of a large gallstone from the gallbladder into the duodenum, causing an obstruction. It is also known as gallstone ileus, which refers to the blockage of the small intestine by a gallstone. This condition typically occurs in elderly individuals with a history of gallstones and can lead to symptoms such as abdominal pain, nausea, and vomiting. Prompt medical intervention is necessary to relieve the obstruction and prevent complications.

This form of perforation is referred to as subacute perforation. It is the most common type and is characterized by a localized rupture in the gallbladder, leading to the formation of a pericholecystic abscess.

A GB polyp, also known as a polyp, is a small mass that forms in the gallbladder. It is typically made up of cholesterol or epithelial cells and protrudes into the lumen on a stalk. These polyps are usually harmless and do not cause any symptoms.

GB polyps can measure anywhere between 2-10 mm. This means that the size of GB polyps can range from 2 mm to 10 mm.

The given answer is "chronic perforation" because it refers to a type of perforation that occurs over a long period of time. This type of perforation can result in the formation of an abnormal fistula internally or a perforation into a neighboring hollow organ. It is specifically associated with a condition called Bouveret's syndrome.

The correct answer is "adenomyomatosis and cholesterolosis." These are the two types of hyperplastic cholecystosis. Adenomyomatosis refers to the hyperplasia of the gallbladder wall, where the muscle layer becomes thickened and forms small outpouchings called Rokitansky-Aschoff sinuses. Cholesterolosis, on the other hand, is the accumulation of cholesterol esters within the gallbladder wall, leading to the formation of yellow plaques or polyps. Both conditions can cause symptoms such as abdominal pain and may require treatment if they become symptomatic or complications arise.

asymptomatic

Mirizzi's syndrome is a rare condition that occurs when a stone becomes lodged in the cystic duct, leading to obstruction of the common hepatic duct (CHD) and intrahepatic ducts. This obstruction can cause symptoms such as jaundice, abdominal pain, and fever. It is important to diagnose and treat Mirizzi's syndrome promptly to prevent complications such as cholangitis or liver abscess. Treatment usually involves surgical removal of the stone and repair of the bile ducts if necessary.

Mirizzi's syndrome is a rare condition characterized by the compression of the common hepatic duct (CHD) by a gallstone impacted in the cystic duct or neck of the gallbladder (GB). This compression leads to obstruction of bile flow and subsequent dilatation of the CHD and intrahepatic radicals. However, the CBD (common bile duct) and GB remain normal in size. Therefore, the statement that the CBD and GB will be normal in size, but causes dilatation of the CHD and intrahepatic radicals is correct.

Adenomyomatosis is a condition characterized by the excessive growth and proliferation of the surface epithelium of the gallbladder, resulting in the formation of gland-like structures and out-pouching of the gallbladder mucosa. This condition is typically benign and may not cause any symptoms in many cases. However, in some instances, it can lead to gallbladder inflammation, pain, and the formation of gallstones. Adenomyomatosis is often detected incidentally during imaging tests performed for other reasons, and treatment is usually not necessary unless symptoms are present or complications arise.

Acute perforation refers to a sudden and severe perforation in the body, which leads to the spread of inflammation throughout the peritoneal membrane. This type of perforation is typically caused by a highly irritating substance, resulting in a widespread inflammatory response in the peritoneum.

a small contracted GB is seen with thickened walls

The correct answer is primary GB cancer and malignant GB cancer. Both terms refer to the same two malignant neoplasms of the gallbladder. The repetition of the terms in the answer options may be a formatting error or a way to emphasize the correct answer.

GB polyps can be single or multiple, and appear as small non-shadowing homogenous intraluminal soft tissue masses. This means that gallbladder polyps can occur as either a solitary growth or multiple growths. When visualized on imaging, these polyps do not cast a shadow and have a consistent texture throughout.

Rokitansky-Aschoff sinuses are small pouches that protrude into the mucosal layer of the tissue. These sinuses are typically found in the gallbladder and are believed to be a result of chronic inflammation. They can vary in size and shape, and their presence is often associated with gallbladder disease. The muscular layer, on the other hand, refers to the layer of smooth muscle that surrounds the mucosal layer.

affects women more than men

The clinical and lab data of GB perforation include leukocytosis, fever, and symptoms similar to acalculous cholecystitis. Leukocytosis refers to an increased number of white blood cells, which is commonly seen in cases of infection or inflammation. The presence of fever indicates an inflammatory response in the body. The symptoms similar to acalculous cholecystitis suggest that the patient may experience pain, tenderness, and inflammation in the gallbladder, even without the presence of gallstones.

Hyperplastic cholecystosis refers to a group of benign non-inflammatory conditions that involve both proliferation and degeneration. This means that there is an abnormal increase in the number of cells in the gallbladder, leading to structural changes and degeneration of the tissue. These conditions are not associated with inflammation, which distinguishes them from other types of cholecystitis. The term "hyperplastic" indicates the excessive cell growth, while "cholecystosis" refers to the involvement of the gallbladder. Therefore, hyperplastic cholecystosis is the correct answer to describe this group of proliferative and degenerative conditions affecting the gallbladder.

Intraluminal diverticula are abnormal pouch-like structures that can form in the walls of the gastrointestinal tract. These diverticula can contain various substances such as bile, sludge, or calculi (stones). Bile is a fluid produced by the liver and stored in the gallbladder, sludge refers to thickened bile or mucus, and calculi are hardened deposits that can form in the gallbladder or bile ducts. Therefore, intraluminal diverticula can potentially contain any combination of these substances.

not a true neoplasm

The correct answer is adenoma, adenomyomatosis, polyp, strawberry GB. These are the four benign neoplasms that can occur in the gallbladder. Adenoma refers to a tumor that arises from glandular tissue, while adenomyomatosis is a condition characterized by hyperplastic changes in the gallbladder wall. Polyps are abnormal growths that can develop on the inner lining of the gallbladder, and strawberry GB is a term used to describe a gallbladder with multiple small cholesterol polyps.

Intraluminal diverticulums can occur diffusely or segmentally, meaning they can be found throughout the entire length of the organ or in specific segments. The MOST COMMON type of intraluminal diverticulum is localized, which means it is found in a specific area or region. In this case, the most common type of intraluminal diverticulum occurs in the fundus, which is the upper portion of the organ.

The sonographic appearance of Primary GB Carcinoma includes areas of necrosis, metastatic invasion into the liver or lymph node, markedly irregular wall thickening, echotexture of mass is heterogenous, complex, or solid, mass fills the entire lumen, larger than a benign lesion, and the need to look for stones or porcelain GB.

Adenomyomatosis is a condition characterized by the presence of comet tail reverberation artifact, focal wall thickening, and anechoic or echogenic foci within the thickened wall on sonographic imaging. The comet tail reverberation artifact refers to the appearance of comet-like tails behind bright echoes, which is a characteristic finding in this condition. Focal wall thickening is seen due to the hypertrophy of the gallbladder wall. Anechoic or echogenic foci within the thickened wall represent cholesterol crystals or calcifications. These findings help in the diagnosis of adenomyomatosis on ultrasound.

The given answer includes a list of symptoms and lab data that are typically associated with chronic cholecystitis. Nausea and/or vomiting, jaundice, RUQ pain, and a history of fatty food intolerance are common symptoms experienced by individuals with chronic cholecystitis. Additionally, increased levels of ALP, bilirubin, ALT, and AST in lab tests can indicate inflammation or dysfunction of the gallbladder, which is characteristic of chronic cholecystitis.

Malignant tumors are rarely encountered as an incidental finding during a screen exam, meaning that they are not often discovered by chance during routine medical examinations. However, they are commonly found during the evaluation of a jaundiced patient, as jaundice can be a symptom of a malignant tumor. Malignant tumors are also frequently found after palpation of a mass in the right upper quadrant (RUQ) of the abdomen, indicating that they can often be detected through physical examination.

bouverets occurs with longstanding untreated chronic cholecystitis