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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
"sparse literature"
symptom
carcinoma of the gallbladder
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