Which findings on CT scans are characteristic of carcinoma of the gallbladder?

Updated: Apr 12, 2018
  • Author: Gregory M Szarnecki, MD; Chief Editor: John Karani, MBBS, FRCR  more...
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Answer

Answer

Computed tomography (CT) scanning can detect GB masses and thickening of the GB wall, as well as the extent of hepatic invasion (see the 2 images below). [9, 10] Peritoneal or distant disease, although uncommon, can be seen.

Computed tomography scan in a 65-year-old man. Thi Computed tomography scan in a 65-year-old man. This image depicts squamous cell carcinoma of the gallbladder and invasion of the liver.
Computed tomography (CT) scan in a 65-year-old man Computed tomography (CT) scan in a 65-year-old man with squamous cell carcinoma of the gallbladder and invasion of the liver (same patient as in the previous image). This CT scan depicts a lower cut through the liver than does the previous image.

Three patterns of findings are identified on CT scans. In 50% of patients, a heterogeneous mass that replaces the GB is present. The term "jam-packed GB" refers to filling of the entire GB lumen by tumor.

Focal or diffuse wall thickening is seen on CT scans in approximately 25% of patients, but this finding is often better appreciated on US. The thickened GB wall may show abnormally bright or persistent enhancement on infused CT scans.

In the remaining 20-25% of patients, a discrete intraluminal mass that enhances heterogeneously is visualized after the administration of intravenous contrast. Trapped stones within the mass may occasionally be seen. CT scans may also show biliary dilatation and metastases.

Xanthogranulomatous cholecystitis is an inflammatory process that cannot be reliably distinguished from GB carcinoma on CT scans because of multiple, overlapping features, such as GB wall thickening and involvement of the surrounding tissues, including portal lymph node, fat, and liver tissue.


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