Gallbladder & extrahepatic bile ducts


Grossing, frozen section & features to report

Last author update: 1 September 2012
Last staff update: 12 February 2021

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PubMed Search: Features to report[TIAB] gallbladder

Hanni Gulwani, M.B.B.S.
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Cite this page: Gulwani H. Grossing, frozen section & features to report. website. Accessed July 5th, 2022.
    Larger masses / carcinoma:
    • Sample tumor thoroughly, margins, normal bile duct
    • Submit several full thickness sections, including areas of deepest penetration
    • Cystic duct margin, hepatic margin, extent of penetration into liver (if applicable)

    Extrahepatic bile ducts:
    • May want to submit entire specimen
    • Submit margins separately, including hepatic margin (if liver tissue present)
Frozen section
  • Optimally should have clinical data and serum AFP levels available
  • Should know if specimen is from a mass
  • Indication: presence of a polypoid mucosal lesion or a suspicious thickening of the gallbladder wall (Arch Pathol Lab Med 2005;129:1610)
Features to report - Gallbladder
  • Tumor size and location
  • Tumor histologic type and pattern
  • Depth of invasion
  • Number and size of tumor nodules
  • Tumor extension to adjacent structures
  • Status of resection margins (cystic duct, liver bed, other)
  • Cystic duct involvement
  • Liver bed involvement
  • Regional lymph nodes: number identified, number with tumor
  • Angiolymphatic invasion
  • Perineural invasion
  • Presence of carcinoma in situ or dysplasia

Additional pathologic findings to report:
  • Chronic cholecystitis, metaplasia (squamous, pyloric gland, intestinal metaplasia), inflammatory bowel disease, porcelain gall bladder, presence or absence of stones (gallbladder cancer occurring without stones may be caused by anomalous choledochopancreatic junction or associated with chronic inflammatory bowel disease, Arch Pathol Lab Med 2000;124:37)
Features to report - Extrahepatic bile ducts
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