Gb Pathology Part 3

GB perforation should be suspected if a localized fluid collection is seen within the GB bed.

• True

• False

What are the 3 typed of GB perforation:

___________ Syndrome is an obstruction of the stomach or duodenum caused by a gallstone that has migrated through a fistula.

In the sonographic appearance of GB perforation, it is common to see an abscess adjacent to the GB with subacute involvement.

• True

• False

_________ cholecystitis is the MOST COMMON form of symptomatic GB disease almost always associated with stones.

Patients with chronic cholecystitis complain of recurrent biliary ______ that lasts for several hours and is caused by transient ___________ of the GB neck or by a stone in the cystic duct.

The "WES" triad is also known as the "_______  _____  _________" sign.

A positive "WES" sign may be identified with chronic cholecystitis.

• True

• False

This is a calcification of the GB wall and is associated with gallstones and chronic cholecystitis.

There is an increased risk of gallbladder cancer with a porcelain GB.

• True

• False

This is an obstruction of the stomach or duodenum caused by a gallstone that has migrated through a fistula.

GB neoplasms can be benign or _________.

This is a benign overgrowth of the GB epithelium and is the MOST COMMON type of benign tumor.

What is the differential diagnosis of adenoma?

This is the most common pseudo-tumor of the GB.

Hyperplasia of the GB epithelium results in diverticulums or sinus formation known as :

Patients with adenomyomatosis are often asymptomatic and is usually seen in women over 40.

• True

• False

Primary GB ________ is rare and only accounts for 4% of all cancers.

98% of gallbladder carcinoma patients will have _______, whereas 25% of patients will have _________ GB.

Patient with primary GB carcinoma may be asymptomatic or present with symptoms similar to __________.

Unlike gallstones, polyps are fixed and DO NOT change position within the GB.

• True

• False

"WES" stands for _____  ______  _________.

Bouveret's syndrome is also known as _________  ______.

This is the MOST COMMON form of perforation and is characterized by a localized rupture that results in the formation of a pericholecystic abscess.

These are small benign cholesterol or epithelial masses that project into the lumen on a stalk, and are more commonly composed of cholesterol.

GB polyps measure anywhere between ___ - ____ mm. (#)

This type of perforation results in an internal abnormal fistula formation or perforation into an adjacent hollow viscous. It is seen with Bouveret's syndrome

What are the 2 types of hyperplastic cholecystosis:

Patients with adenoma are usually symptomatic.

• True

• False

This syndrome is caused by a stone that gets stuck in the cystic duct causing obstruction of the CHD and intrahepatic ducts.

With Mirizzi's Syndrome, the CBD and GB will be normal in size, but causes dilatation of the CHD and intrahepatic radicals.

• True

• False

Excessive proliferation of the surface epithelium of the GB with gland like formations and out-pouching's of the GB mucosa, is known as:

________ perforation is a free perforation that results in generalized peritonitis. It is a very irritating substance that results in _______ of peritoneal membrane.

With chronic cholecystitis, an enlarged GB is seen with thickened walls.

• True

• False

Name the 2 malignant GB neoplasms:

GB polyps can be single or ________, and appear as small ____________ homogenous intraluminal soft tissue masses.

Rokitansky-Aschoff sinuses are ________ out-pouching's extending into the ________ layer.

Primary GB carcinoma affects men more than women over the age of 60.

• True

• False

Clinical and lab data of GB perforation:

• Leukocytosis

• Similar to calculous cholecystitis

• Fever

• Similar to acalculous cholecystitis

This represents a group of benign non-inflammatory conditions that are both proliferative and degenerative.

Intraluminal diverticulums' may contain ________, _________, or _________.

A polyp is a true neoplasm.

• True

• False

Name the 4 benign GB neoplasms: (ALpHABETICALLY)

Intraluminal diverticulums can occur diffusely or _________ and the MOST COMMON type is _________ and occurs in the fundus.

Check all that apply to the sonographic appearance of Primary GB Carcinoma:

• Homogenous mass

• Areas of necrosis

• Metastatic invasion into the liver or lymph node

• Markedly irregular wall thickening

• Echotexture of mass is heterogenous, complex, or solid

• Smaller than benign lesion

• Mass fills entire lumen

• Larger than benign lesion

• Look for stones or porcelain GB

Sonographic appearance of Adenomyomatosis:

• Comet tail reverberation artifact

• Focal wall thickening

• Anechoic or echogenic foci visible within the thickened wall

Clinical and lab data of chronic cholecystitis:

• Nausea and/or vomiting

• Jaundice

• RUQ pain

• History of fatty food intolerance

• Increased ALP, bilirubin, ALT and AST

Malignant tumors are encountered in 3 clinical situations:

• Rarely appears as an incidental finding during a screen exam

• Not commonly found after palpation of RUQ mass

• Malignant tumors are found during evaluation of a jaundiced patient

• Frequently found after palpation of RUQ mass