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Preoperative diagnosis of squamous cell carcinoma of the gallbladder by ultrasound-guided aspiration cytology: clinical and cytological findings of nine cases.
[carcinoma of the gallbladder]
Squamous
cell
carcinoma
is
a
rare
tumour
of
the
gallbladder
and
accounts
for
about
1
%
of
all
the
malignant
neoplasms
of
the
gallbladder
.
The
clinical
presentation
of
patients
with
squamous
cell
carcinoma
of
the
gallbladder
is
not
specific
,
and
in
majority
,
it
mimics
that
of
acute
cholecystitis
.
As
a
result
,
preoperative
diagnosis
is
not
made
,
and
patients
undergo
operative
procedures
.
Squamous
cell
carcinoma
of
the
gallbladder
is
detected
at
an
advanced
stage
with
infiltration
into
adjacent
structures
,
with
infiltration
of
the
liver
being
the
commonest
.
Ultrasound-guided
fine-needle
aspiration
cytology
is
considered
an
important
minimally
invasive
investigation
in
the
preoperative
diagnosis
of
adenocarcinoma
of
the
gallbladder
.
However
,
sparse
literature
is
available
regarding
preoperative
fine-needle
aspiration
diagnosis
of
squamous
cell
carcinoma
of
the
gallbladder
.
On
retrospective
analysis
of
ultrasound-guided
fine-needle
aspiration
cytology
of
gallbladder
lesions
,
nine
cases
of
pure
squamous
cell
carcinoma
were
identified
.
Clinical
and
cytopathological
features
were
analysed
for
these
cases
and
compared
with
those
of
adenocarcinoma
of
the
gallbladder
.
Patients
presented
with
non-
specific
abdominal
symptoms
,
and
on
radiological
assessment
,
eight
out
of
nine
cases
had
evidence
of
local
infiltration
.
Four
of
these
cases
had
pathologically
documented
evidence
of
liver
infiltration
.
Cytology
showed
presence
of
atypical
squamous
cells
with
keratinized
cytoplasm
,
tadpole
cells
and
giant
cells
along
with
necrosis
.
Eight
of
the
nine
cases
were
inoperable
,
and
only
a
single
patient
underwent
hepatopancreaticoduodenectomy
along
with
cholecystectomy
.
Three
patients
received
cisplatin
and
gemcitabine-based
chemotherapy
.
Ultrasound-guided
fine-needle
aspiration
is
a
useful
minimally
invasive
investigation
in
the
preoperative
diagnosis
of
squamous
cell
carcinoma
of
the
gallbladder
and
can
be
helpful
in
deciding
the
management
and
prognostication
of
the
patient
.
Diseases
Validation
Diseases presenting
"single patient"
symptom
carcinoma of the gallbladder
epidermolysis bullosa simplex
esophageal carcinoma
fabry disease
hereditary cerebral hemorrhage with amyloidosis
lamellar ichthyosis
neuralgic amyotrophy
pendred syndrome
scrub typhus
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