Gallbladder & extrahepatic bile ducts
General
Grossing, frozen section & features to report
Author: Hanni Gulwani, M.B.B.S.
Last author update: 1 September 2012
Last staff update: 17 April 2024
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Features to report gallbladder
Table of Contents
Grossing | Frozen section | Features to report - Gallbladder | Features to report - Extrahepatic bile ducts | Organizational checklistsCite this page: Gulwani H. Grossing, frozen section & features to report. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/gallbladderfeaturestoreport.html. Accessed April 18th, 2024.
Grossing
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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)
- May want to submit entire specimen
- Submit margins separately, including hepatic margin (if liver tissue present)
Extrahepatic bile ducts:
Frozen section
- Click here for the frozen section procedure topic
- 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
- Bile duct wall thickness, external surface, obstruction, stones
- Tumor size and location
- Tumor histologic type, pattern and grade
- Depth of invasion
- Number and size of tumor nodules
- Tumor extension to adjacent structures
- Status of resection margins
- Regional lymph nodes: number identified, number with tumor
- Angiolymphatic invasion
- Perineural invasion
- Presence of carcinoma in situ or dysplasia
- References: Arch Pathol Lab Med 2000;124:26, Arch Pathol Lab Med 2010;134:e8, CAP: Protocol for the Examination of Specimens From Patients With Carcinoma of the Distal Extrahepatic Bile Ducts [Accessed 8 February 2018]
