Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Dr. Pedram Argani and prepared by Dr. Kevan Salimian
This is a 46 year old male with polyp in gallbladder.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
This is a 46 year old male with polyp in gallbladder. The surrounding gallbladder mucosa was unremarkable. Choose the correct diagnosis.
Correct
Answer: Pyloric gland adenoma with high grade dysplasia
Histology Description: This is a polypoid lesion that is composed of cuboidal cells that have round nuclei. The architecture is complex, and there is increased nucleus to cytoplasm ratio. Focally, there is suggestion of squamoid morule formation. These features suggest the diagnosis of pyloric gland adenoma with superimposed high grade dysplasia. The diagnosis is supported by immunohistochemistry for beta-catenin, which demonstrates diffuse nuclear and cytoplasmic labeling of the lesion but not the surrounding mucosa.
Differential Diagnosis: Cholesterol polyp consists of unremarkable gallbladder epithelium and prominent cholesterol-laden macrophages. Adenocarcinoma of the gallbladder would demonstrate stromal reaction and greater cytologic atypia. Intestinal type dysplasias are associated with goblet cells, and importantly typically involve the surrounding gallbladder mucosa, not just the polyp.
Pyloric gland adenomas of the gallbladder typically arise in pristine mucosa, form polyps that often detach and simulate stones, have squamoid morules, and harbor beta-catenin mutations.Reference: Chang Am J Surg Pathol 2002; 26:758-766.
Incorrect
Answer: Pyloric gland adenoma with high grade dysplasia
Histology Description: This is a polypoid lesion that is composed of cuboidal cells that have round nuclei. The architecture is complex, and there is increased nucleus to cytoplasm ratio. Focally, there is suggestion of squamoid morule formation. These features suggest the diagnosis of pyloric gland adenoma with superimposed high grade dysplasia. The diagnosis is supported by immunohistochemistry for beta-catenin, which demonstrates diffuse nuclear and cytoplasmic labeling of the lesion but not the surrounding mucosa.
Differential Diagnosis: Cholesterol polyp consists of unremarkable gallbladder epithelium and prominent cholesterol-laden macrophages. Adenocarcinoma of the gallbladder would demonstrate stromal reaction and greater cytologic atypia. Intestinal type dysplasias are associated with goblet cells, and importantly typically involve the surrounding gallbladder mucosa, not just the polyp.
Pyloric gland adenomas of the gallbladder typically arise in pristine mucosa, form polyps that often detach and simulate stones, have squamoid morules, and harbor beta-catenin mutations.Reference: Chang Am J Surg Pathol 2002; 26:758-766.
