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Gallbladder carcinoma: An attempt of WHO histological classification on fine needle aspiration material.
[carcinoma of the gallbladder]
Carcinoma
of
the
gallbladder
(
CaGB
)
is
common
in
India
and
its
prognosis
depends
primarily
on
the
extent
of
the
disease
and
histological
type
.
We
aim
to
study
the
role
of
guided
fine
needle
aspiration
cytology
(
FNAC
)
for
diagnosis
of
CaGB
and
to
evaluate
the
feasibility
of
applying
world
health
organization
(
WHO
)
classification
on
fine
needle
aspiration
(
FNA
)
material
to
predict
the
outcome
of
the
tumor
.
Retrospective
cytomorphologic
analysis
was
performed
in
all
cases
of
CaGB
diagnosed
by
ultrasound
(
US
)
guided
FNAC
over
a
period
of
2
years
.
A
specific
subtype
was
assigned
according
to
WHO
classification
based
on
characteristic
cytologic
features
.
These
included
papillary
or
acinar
arrangement
,
intra
and
extracellular
mucin
,
keratin
,
rosettes
and
columnar
,
signet
ring
,
atypical
squamous
,
small
,
clear
,
spindle
and
giant
cells
.
Correlation
with
histopathology
was
performed
when
available
.
A
total
of
541
aspirations
with
clinical
or
radiological
suspicion
of
primary
CaGB
were
studied
.
Of
these
,
54
aspirates
were
unsatisfactory
.
Fifty
cases
were
negative
for
malignancy
.
Remaining
437
aspirates
were
positive
for
carcinoma
.
Histopathologic
diagnosis
was
available
in
32
cases
.
Adenocarcinoma
was
the
most
frequent
diagnosis
in
86
.
7
%
of
cases
.
Mucinous
,
signet
ring
,
adenosquamous
,
squamous
,
small
cell
,
mixed
adenoneuroendocrine
and
undifferentiated
carcinoma
including
spindle
and
giant
cell
subtypes
were
diagnosed
identifying
specific
features
on
FNAC
.
Correlation
with
histopathology
was
present
in
all
,
but
one
case
giving
rise
to
sensitivity
of
96
.
8
%
.
No
post-
FNA
complications
were
recorded
.
US
guided
FNAC
is
a
safe
and
effective
method
to
diagnose
CaGB
.
Although
,
rare
,
clinically
and
prognostically
significant
variants
described
in
WHO
classification
can
be
detected
on
cytology
.
Diseases
Validation
Diseases presenting
"characteristic cytologic features"
symptom
carcinoma of the gallbladder
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