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Porcelain Gallbladder
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Written by Dr Sebastian Zeki
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Porcelain Gallbladder
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Written by Dr Sebastian Zeki
Histopathology:
Epidemiology
The incidence is 0.1% .
M:F= 1:5 .
Mean age is 50.
15% get gallbladder cancer.
Ultrasonographic Types
Histopathological Types
Corresponds With
AXR-
Calcifications
are in RUQ
Porcelain Gallbladder
Treatment-
Treat with an open cholecystectomy even if asymptomatic (lap difficult as cant grab it easily).
Incomplete type
— Calcification of the gallbladder wall
is milder and there is incomplete exfoliation of the
mucosal epithelium.
High risk of gallbladder cancer as still have some mucosa
Complete type
— Gallbladder wall completely replaced
by dense fibrosis or calcification. Calcification is so severe
that the mucosal epithelium is peeled off.
Type III
— Irregular clumps of echoes
with posterior acoustic shadowing
Type II
— A biconvex curvilinear echogenic
appearance with acoustic shadowing
Type I
— A hyperechoic semilunar
appearance with posterior acoustic
shadowing.
Often asymptomatic,
Some present with biliary type pain.
Rarely- firm, nontender mass in the RUQ
Pathogenesis
Gallbladder wall injury is due to chronic
irritation by gallstones.
Mucosal precipitation of calcium carbon
-
ate salts occurs in inflamed tissue.
80% of cancer associated with
porcelain GB are adenoca
2 forms:
a)Broad muscularis band (plaque-
like on radiology)
b) Multiple punctate calcifications
in the glandular spaces of the
mucosa, granular calcifications on
radiology.
=Intramural calcification of the gallbladder wall.