More than 90 % of gall bladder cancers are adenocarcinoma. Adenocarcinoma
— tubular/acinar: usual type and a well to moderately differentiated biliary pattern of low cuboidal to tall columnar cells.
— papillary: polypoid/well differentiated/better prognosis.
— intestinal/mucinous/signet ring cell/clear cell: unusual. Distinguish from metastatic stomach or bowel cancer by adjacent mucosal dysplasia. Mucinous/signet ring cell carcinomas require >50% of the tumour to be composed of this pattern.
Small cell carcinoma
— and other neuroendocrine lesions, e.g. carcinoid/large cell neuroendocrine carcinoma including composite tumours (carcinoid/ adenocarcinoma).
— small cell carcinoma is aggressive and may be a component of usual adenocarcinoma.
Spindle cell carcinoma/carcinosarcoma
— biphasic carcinoma/sarcoma-like components ± specific mesenchymal differentiation. These represent carcinomas with variable stromal differentiation and overlap with undifferentiated carcinoma.
— elderly patients, poor prognosis.
— nodular and solid/spindle cell/giant cell/osteoclast-like giant cell variants.
— secondary (15% of disseminated melanoma at autopsy) or rarely primary (nodular, adjacent mucosal junctional change).
— direct spread: stomach, colon, pancreas, cholangiocarcinoma.
— distant spread: breast, lung, kidney.
Note that cystic duct carcinoma is classified as a tumour of the extra-hepatic bile ducts.
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Complete Guide to Preventing Skin Cancer. We all know enough to fear the name, just as we do the words tumor and malignant. But apart from that, most of us know very little at all about cancer, especially skin cancer in itself. If I were to ask you to tell me about skin cancer right now, what would you say? Apart from the fact that its a cancer on the skin, that is.