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Clinical Pathology & Research Journal Research Article 1 min read

A Rare Malignant Tumor of Gall Bladder

Agarwal L*
* Corresponding author
ISSN: 2642-6145  10.23880/cprj-16000127  Received: October 15, 2020  Published: January 25, 2021
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Keywords
Rare Malignant Tumor Gall Bladder Radical Cholecystectomy
Abstract

A 35 yrs old lady presented with abdominal pain and loss of appetite. LFT, RFT and other Lab investigation were within normal limits. USG findings showed mass in GB with multiple para aortic nodes. Liver was unremarkable.CA 19.9 and CEA were within normal limits.

Introduction

A 35 yrs old lady presented with abdominal pain and loss of appetite. LFT, RFT and other Lab investigation were within normal limits. USG findings showed mass in GB with Image Article multiple para aortic nodes. Liver was unremarkable.CA 19.9 and CEA were within normal limits. Radical Cholecystectomy was done (Figures 1-5).

Following are the images.

Figure 1: Resected specimen.
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Figure 1: Resected specimen.
Figure 2: Gross image showing polypoidal growth.
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Figure 2: Gross image showing polypoidal growth.
Figure 3: Microscopy image, H&E, 20X, showing infiltrating malignant glands.
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Figure 3: Microscopy image, H&E, 20X, showing infiltrating malignant glands.
Figure 4: 40X, H & E, pleomorphic malignant spindle cell.
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Figure 4: 40X, H & E, pleomorphic malignant spindle cell.
Figure 5: 40X, H&E, neuroendocrine differentiation.
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Figure 5: 40X, H&E, neuroendocrine differentiation.

Diagnosis

Microscopic Description

  • This is an undifferentiated malignant neoplasm showing carcinoma (approximately 20%), sarcomatous(approximately 70%) and neuroendocrine differentiation in 10% Immunohistochemistry
  • Carcinomatous area are immunopositive for Pancytokeratin, Synaptophysin and ChromograninA
  • Sarcomatous area immunopositive for SMA, Desmin (in area with rhabdoid differentiation)), Vimentin
  • Both the component are immunonegative for Glypican III, SALL4, CD 117 and PLAP.
  • ki 67 proliferation index, high 75-80%.

Diagnosis

  • Undifferentiated malignant neoplasm with carcinomatous, areas of neurodenodcrine carcinoma and sarcomatoid area with heteologous elements (Leiomyosarcoma and rhabdomyosarcoma)
  • Rare and aggressive tumor
  • Difficult to differentiate from adenocarcinoma preoperative
  • CA19.9 is normal or mildly increased compared to disease burden
  • Surgery is only treatment if the disease is confined
  • Prognosis is very poor
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@article{agarwal2021,
  title   = {A Rare Malignant Tumor of Gall Bladder},
  author  = {Agarwal L},
  journal = {Clinical Pathology & Research Journal},
  year    = {2021},
  volume  = {5},
  number  = {1},
  doi     = {10.23880/cprj-16000127}
}
Agarwal L (2021). A Rare Malignant Tumor of Gall Bladder. Clinical Pathology & Research Journal, 5(1). https://doi.org/10.23880/cprj-16000127
TY  - JOUR
TI  - A Rare Malignant Tumor of Gall Bladder
AU  - Agarwal L
JO  - Clinical Pathology & Research Journal
PY  - 2021
VL  - 5
IS  - 1
DO  - 10.23880/cprj-16000127
ER  -