The Experts below are selected from a list of 261 Experts worldwide ranked by ideXlab platform
Donald E. Henson - One of the best experts on this subject based on the ideXlab platform.
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Rokitansky-Aschoff Sinuses mimicking adenocarcinoma of the gallbladder: a study of 8 cases.
The American journal of surgical pathology, 2013Co-Authors: Rita Dorantes-heredia, Donald E. Henson, Fredy Chablé-montero, Jorge Albores-saavedraAbstract:Abstract We describe 8 cases of cholecystectomy specimens (6 laparoscopic and 2 open cholecystectomies) with Rokitansky-Aschoff (R-A) Sinuses that were misinterpreted as adenocarcinomas. They were compared with 8 examples of classical R-A Sinuses and 6 cases of R-A Sinuses containing foci of adenocarcinoma. Five cases misinterpreted as adenocarcinomas consisted of densely packed, closely opposed R-A Sinuses with little intervening stroma or surrounded by a desmoplastic stroma. They were lined by a single layer of cuboidal or columnar cells. There were also pseudostratified columnar cells with mucin-containing cytoplasm and hyperchromatic or vesicular nuclei but without mitotic figures. In 2 cases, the columnar cells had subnuclear vacuoles. Small papillary projections into R-A Sinuses were seen in 4 cases, and in 3 others collections of metaplastic pyloric glands, some connected to the epithelium of the Sinuses, were recognized. There was focal reactive atypia in both the epithelium of the surface and that of the Sinuses. The R-A Sinuses resembling gland-like structures had a laminar distribution rather than a disorderly haphazard distribution seen in well-differentiated adenocarcinoma. The remaining 3 cases misinterpreted as adenocarcinomas consisted of numerous deeply penetrating long and short R-A Sinuses that branched in different directions and which reach the subserosal or perimuscular connective tissue mimicking invasion. The Sinuses were surrounded by hyperplastic smooth muscle bundles and lined by pseudostratified columnar cells mixed with a few goblet cells showing reactive atypia and no mitotic figures. There was focal reactive atypia in both the epithelium of the surface and that of the Sinuses. The 2 types of R-A Sinuses did not label with carcinoembryonic antigen or p53 and had very low proliferative activity as measured by the MIB1-labeling index. All patients are alive and disease free from 8 months to 17 years (mean follow-up 7 y). In contrast, the foci of invasive adenocarcinoma that arose in R-A Sinuses consisted of glands lined by atypical cuboidal or columnar cells with loss of polarity, large hyperchromatic or vesicular nuclei, prominent nucleoli, and mitotic figures, quite different from the cells lining the R-A Sinuses. Because of increasing number of laparoscopic cholecystectomies performed annually in the United States, pathologists should become familiar with these gallbladder lesions that are usually incidental findings but can simulate malignant epithelial neoplasms.
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Mucin-containing Rokitansky-Aschoff Sinuses with extracellular mucin deposits simulating mucinous carcinoma of the gallbladder.
The American journal of surgical pathology, 2009Co-Authors: Jorge Albores-saavedra, Carlos A. Galliani, Fredy Chablé-montero, Kristen A. Batich, Donald E. HensonAbstract:Rokitansky-Aschoff Sinuses (R-As) are epithelial invaginations that extend down the gallbladder wall through the smooth muscle gaps and by this pathway they reach the subserosal connective tissue. We report here 5 cases of mucin-containing R-As that ruptured, and as a result, extracellular mucin escaped into the adjacent stroma. They were compared with 10 mucinous carcinomas of the gallbladder. Three cases of mucin-containing R-As accompanied by abundant extracellular mucin deposits with epithelial strips, glands and papillary structures were misinterpreted as mucinous carcinomas. Because of this, the patients were subjected to a second unnecessary radical surgical procedure. In the remaining 2 cases, the extracellular mucin associated with R-As was acellular and regarded as focal. Three patients were men and 2 women whose ages ranged from 2 to 71 years (average age 52 y). The youngest patient was a 2-year-old boy in whom the mucin-containing R-As were discovered incidentally by magnetic resonance imaging. He was later diagnosed with metachromatic leukodystrophy. The remaining 4 patients complained of right upper quadrant pain and had a thickened gallbladder wall identified by computed tomography and magnetic resonance imaging. There were gallstones in 3 patients. The R-As located in the lamina propria contained mucin but were not cystically dilated whereas those located in the subserosa were mucin-filled and often cystically dilated. Detached fragments of biliary epithelium, small glands, and papillary structures lacking cytologic atypia and mitotic figures were identified in the abundant mucin deposits located in the subserosa of 3 cases. The overlying surface gallbladder epithelium exhibited papillary hyperplasia with focal intestinal metaplasia in 2 patients, one of which had metachromatic leukodystrophy. The lack of reactivity for carcinoembryonic antigen and p53 and the low proliferative activity as measured by MIB-1 labeling index provided additional support to the benign nature of the lesion. Clues to separate mucin-containing R-As from mucinous carcinoma are provided. All 5 patients with mucin-containing R-As are disease free 8 months to 7 years after surgery (median follow-up of 39 mo).
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Adenomyomatous hyperplasia of the gallbladder with perineural invasion: revisited.
The American journal of surgical pathology, 2007Co-Authors: Jorge Albores-saavedra, Brent Keenportz, Pablo A. Bejarano, Alan A.z. Alexander, Donald E. HensonAbstract:We report 9 examples of segmental adenomyomatous hyperplasia of the gallbladder with perineural invasion. Five patients were women and 4 men. Their ages ranged from 49 to 81 years (mean age 64 y). Eight patients had gallbladder calculi. The original pathologic diagnosis of adenocarcinoma was made in 5 patients and of "adenoma malignum" in one. Six patients are disease-free for 2 to 11 years following cholecystectomy, 1 patient died of unrelated causes and 2 were lost to follow-up. Histologically 2 types of adenomyomatous hyperplasia were recognized. The first one characterized by numerous Rokitansky-Aschoff Sinuses (RASs) was accompanied by smooth muscle hyperplasia and an expanded subserosal layer containing numerous nerve trunks (6 cases). The second type was characterized by an extensively fibrotic gallbladder wall with numerous RASs but with few or no smooth muscle bundles and an expanded subserosal layer containing abundant nerve-trunks (3 cases). Perineural (7 cases) and intraneural invasion (2 cases) was identified only in the subserosal layer. The lack of p53 reactivity and the very low MIB-1-labeling index provide additional support to the non-neoplastic nature of the lesion. The pseudoinvasive pattern of the RASs, reactive epithelial atypia, and the perineural and intraneural invasion probably contributed to the erroneous diagnosis of adenocarcinoma or "adenoma malignum." The mechanism by which the epithelial structures "invaded" the perineural spaces and the nerves is unclear. We favor the hypothesis that the migration of the benign glandlike structures into the nerves is related to the production of chemotactic factors or signaling substances and the activation of cell receptors.
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In situ and invasive adenocarcinomas of the gallbladder extending into or arising from Rokitansky-Aschoff Sinuses: A clinicopathologic study of 49 cases
The American journal of surgical pathology, 2004Co-Authors: Jorge Albores-saavedra, Deepti Shukla, Kelley S. Carrick, Donald E. HensonAbstract:We report 49 cases of gallbladder carcinomas that extended into or originated from Rokitansky-Aschoff Sinuses (RAS), all of which were resected by laparoscopic cholecystectomy. Twenty-one tumors were in situ carcinomas that extended along RAS; six in situ carcinomas arose in adenomyomatous hyperplasia and 22 were invasive adenocarcinomas with extension into RAS. Thirty-seven patients were women and 12 men. Forty patients had cholelithiasis. The age of the patients ranged from 55 to 84 years (mean 67 years). All in situ carcinomas were incidental microscopic findings in gallbladders removed for cholelithiasis and/or cholecystitis. No patient with in situ carcinoma died as a result of the tumor, including two with in situ carcinoma that originated in adenomyomatous hyperplasia and showed microinvasion. In contrast, of 15 patients with invasive well to moderately differentiated adenocarcinoma extending into RAS and invading the muscle layer or subserosal connective tissue, 8 died 2 to 4 years after surgery. Seven patients survived 1 to 8 years after cholecystectomy. Useful clues to separate RAS with in situ carcinoma from tubular neoplastic invasive glands were the following: connection of the epithelial invaginations to the surface epithelium, recognition of normal biliary epithelium admixed with neoplastic epithelium, presence of inspissated bile in long dilated spaces, and lack of invasion to the smooth muscle bundles. In situ carcinoma spreading along RAS consisted of long tubular often dilated structures extending through the intermuscular connective tissue, whereas neoplastic glands were usually small or of medium size that invaded smooth muscle bundles or intermuscular connective tissue. Perineural invasion was seen only in invasive glands located in the subserosal connective tissue. Two cases of in situ carcinoma that arose in adenomyomatous hyperplasia and three invasive adenocarcinomas that were composed predominantly of tall columnar mucin containing cells similar to gastric foveolar cells with varying degrees of atypia and cells with biliary phenotype bear some resemblance to intraductal papillary mucinous carcinoma of the pancreas or to mucinous cystic pancreatic neoplasm. Metaplastic pyloric glands often seen in the muscle layer and subserosal connective tissue maintain their lobular pattern and should not be confused with invasive glands. Our findings indicate that distinction of in situ carcinoma spreading into RAS from tubular neoplastic glands of invasive adenocarcinomas is crucial to determine prognosis in this group of patients with gallbladder carcinoma.
Jorge Albores-saavedra - One of the best experts on this subject based on the ideXlab platform.
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Rokitansky-Aschoff Sinuses mimicking adenocarcinoma of the gallbladder: a study of 8 cases.
The American journal of surgical pathology, 2013Co-Authors: Rita Dorantes-heredia, Donald E. Henson, Fredy Chablé-montero, Jorge Albores-saavedraAbstract:Abstract We describe 8 cases of cholecystectomy specimens (6 laparoscopic and 2 open cholecystectomies) with Rokitansky-Aschoff (R-A) Sinuses that were misinterpreted as adenocarcinomas. They were compared with 8 examples of classical R-A Sinuses and 6 cases of R-A Sinuses containing foci of adenocarcinoma. Five cases misinterpreted as adenocarcinomas consisted of densely packed, closely opposed R-A Sinuses with little intervening stroma or surrounded by a desmoplastic stroma. They were lined by a single layer of cuboidal or columnar cells. There were also pseudostratified columnar cells with mucin-containing cytoplasm and hyperchromatic or vesicular nuclei but without mitotic figures. In 2 cases, the columnar cells had subnuclear vacuoles. Small papillary projections into R-A Sinuses were seen in 4 cases, and in 3 others collections of metaplastic pyloric glands, some connected to the epithelium of the Sinuses, were recognized. There was focal reactive atypia in both the epithelium of the surface and that of the Sinuses. The R-A Sinuses resembling gland-like structures had a laminar distribution rather than a disorderly haphazard distribution seen in well-differentiated adenocarcinoma. The remaining 3 cases misinterpreted as adenocarcinomas consisted of numerous deeply penetrating long and short R-A Sinuses that branched in different directions and which reach the subserosal or perimuscular connective tissue mimicking invasion. The Sinuses were surrounded by hyperplastic smooth muscle bundles and lined by pseudostratified columnar cells mixed with a few goblet cells showing reactive atypia and no mitotic figures. There was focal reactive atypia in both the epithelium of the surface and that of the Sinuses. The 2 types of R-A Sinuses did not label with carcinoembryonic antigen or p53 and had very low proliferative activity as measured by the MIB1-labeling index. All patients are alive and disease free from 8 months to 17 years (mean follow-up 7 y). In contrast, the foci of invasive adenocarcinoma that arose in R-A Sinuses consisted of glands lined by atypical cuboidal or columnar cells with loss of polarity, large hyperchromatic or vesicular nuclei, prominent nucleoli, and mitotic figures, quite different from the cells lining the R-A Sinuses. Because of increasing number of laparoscopic cholecystectomies performed annually in the United States, pathologists should become familiar with these gallbladder lesions that are usually incidental findings but can simulate malignant epithelial neoplasms.
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Mucin-containing Rokitansky-Aschoff Sinuses with extracellular mucin deposits simulating mucinous carcinoma of the gallbladder.
The American journal of surgical pathology, 2009Co-Authors: Jorge Albores-saavedra, Carlos A. Galliani, Fredy Chablé-montero, Kristen A. Batich, Donald E. HensonAbstract:Rokitansky-Aschoff Sinuses (R-As) are epithelial invaginations that extend down the gallbladder wall through the smooth muscle gaps and by this pathway they reach the subserosal connective tissue. We report here 5 cases of mucin-containing R-As that ruptured, and as a result, extracellular mucin escaped into the adjacent stroma. They were compared with 10 mucinous carcinomas of the gallbladder. Three cases of mucin-containing R-As accompanied by abundant extracellular mucin deposits with epithelial strips, glands and papillary structures were misinterpreted as mucinous carcinomas. Because of this, the patients were subjected to a second unnecessary radical surgical procedure. In the remaining 2 cases, the extracellular mucin associated with R-As was acellular and regarded as focal. Three patients were men and 2 women whose ages ranged from 2 to 71 years (average age 52 y). The youngest patient was a 2-year-old boy in whom the mucin-containing R-As were discovered incidentally by magnetic resonance imaging. He was later diagnosed with metachromatic leukodystrophy. The remaining 4 patients complained of right upper quadrant pain and had a thickened gallbladder wall identified by computed tomography and magnetic resonance imaging. There were gallstones in 3 patients. The R-As located in the lamina propria contained mucin but were not cystically dilated whereas those located in the subserosa were mucin-filled and often cystically dilated. Detached fragments of biliary epithelium, small glands, and papillary structures lacking cytologic atypia and mitotic figures were identified in the abundant mucin deposits located in the subserosa of 3 cases. The overlying surface gallbladder epithelium exhibited papillary hyperplasia with focal intestinal metaplasia in 2 patients, one of which had metachromatic leukodystrophy. The lack of reactivity for carcinoembryonic antigen and p53 and the low proliferative activity as measured by MIB-1 labeling index provided additional support to the benign nature of the lesion. Clues to separate mucin-containing R-As from mucinous carcinoma are provided. All 5 patients with mucin-containing R-As are disease free 8 months to 7 years after surgery (median follow-up of 39 mo).
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Adenomyomatous hyperplasia of the gallbladder with perineural invasion: revisited.
The American journal of surgical pathology, 2007Co-Authors: Jorge Albores-saavedra, Brent Keenportz, Pablo A. Bejarano, Alan A.z. Alexander, Donald E. HensonAbstract:We report 9 examples of segmental adenomyomatous hyperplasia of the gallbladder with perineural invasion. Five patients were women and 4 men. Their ages ranged from 49 to 81 years (mean age 64 y). Eight patients had gallbladder calculi. The original pathologic diagnosis of adenocarcinoma was made in 5 patients and of "adenoma malignum" in one. Six patients are disease-free for 2 to 11 years following cholecystectomy, 1 patient died of unrelated causes and 2 were lost to follow-up. Histologically 2 types of adenomyomatous hyperplasia were recognized. The first one characterized by numerous Rokitansky-Aschoff Sinuses (RASs) was accompanied by smooth muscle hyperplasia and an expanded subserosal layer containing numerous nerve trunks (6 cases). The second type was characterized by an extensively fibrotic gallbladder wall with numerous RASs but with few or no smooth muscle bundles and an expanded subserosal layer containing abundant nerve-trunks (3 cases). Perineural (7 cases) and intraneural invasion (2 cases) was identified only in the subserosal layer. The lack of p53 reactivity and the very low MIB-1-labeling index provide additional support to the non-neoplastic nature of the lesion. The pseudoinvasive pattern of the RASs, reactive epithelial atypia, and the perineural and intraneural invasion probably contributed to the erroneous diagnosis of adenocarcinoma or "adenoma malignum." The mechanism by which the epithelial structures "invaded" the perineural spaces and the nerves is unclear. We favor the hypothesis that the migration of the benign glandlike structures into the nerves is related to the production of chemotactic factors or signaling substances and the activation of cell receptors.
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In situ and invasive adenocarcinomas of the gallbladder extending into or arising from Rokitansky-Aschoff Sinuses: A clinicopathologic study of 49 cases
The American journal of surgical pathology, 2004Co-Authors: Jorge Albores-saavedra, Deepti Shukla, Kelley S. Carrick, Donald E. HensonAbstract:We report 49 cases of gallbladder carcinomas that extended into or originated from Rokitansky-Aschoff Sinuses (RAS), all of which were resected by laparoscopic cholecystectomy. Twenty-one tumors were in situ carcinomas that extended along RAS; six in situ carcinomas arose in adenomyomatous hyperplasia and 22 were invasive adenocarcinomas with extension into RAS. Thirty-seven patients were women and 12 men. Forty patients had cholelithiasis. The age of the patients ranged from 55 to 84 years (mean 67 years). All in situ carcinomas were incidental microscopic findings in gallbladders removed for cholelithiasis and/or cholecystitis. No patient with in situ carcinoma died as a result of the tumor, including two with in situ carcinoma that originated in adenomyomatous hyperplasia and showed microinvasion. In contrast, of 15 patients with invasive well to moderately differentiated adenocarcinoma extending into RAS and invading the muscle layer or subserosal connective tissue, 8 died 2 to 4 years after surgery. Seven patients survived 1 to 8 years after cholecystectomy. Useful clues to separate RAS with in situ carcinoma from tubular neoplastic invasive glands were the following: connection of the epithelial invaginations to the surface epithelium, recognition of normal biliary epithelium admixed with neoplastic epithelium, presence of inspissated bile in long dilated spaces, and lack of invasion to the smooth muscle bundles. In situ carcinoma spreading along RAS consisted of long tubular often dilated structures extending through the intermuscular connective tissue, whereas neoplastic glands were usually small or of medium size that invaded smooth muscle bundles or intermuscular connective tissue. Perineural invasion was seen only in invasive glands located in the subserosal connective tissue. Two cases of in situ carcinoma that arose in adenomyomatous hyperplasia and three invasive adenocarcinomas that were composed predominantly of tall columnar mucin containing cells similar to gastric foveolar cells with varying degrees of atypia and cells with biliary phenotype bear some resemblance to intraductal papillary mucinous carcinoma of the pancreas or to mucinous cystic pancreatic neoplasm. Metaplastic pyloric glands often seen in the muscle layer and subserosal connective tissue maintain their lobular pattern and should not be confused with invasive glands. Our findings indicate that distinction of in situ carcinoma spreading into RAS from tubular neoplastic glands of invasive adenocarcinomas is crucial to determine prognosis in this group of patients with gallbladder carcinoma.
Francesco Cetta - One of the best experts on this subject based on the ideXlab platform.
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Rokitansky-Aschoff Sinuses of the Gallbladder are Associated with Black Pigment Gallstone Formation: A Scanning Electron Microscopy Study
Ultrastructural pathology, 2003Co-Authors: Andrea Cariati, Francesco CettaAbstract:Rokitansky-Aschoff Sinuses are the result of hyperplasia and herniation of epithelial cells through the fibromuscular layer of the gallbladder wall and are usually referred to as adenomyomatosis. The role of this study is to demonstrate that Rokitansky-Aschoff Sinuses of the gallbladder are a risk factor for the formation of black pigment gallstones. A total of 179 removed gallbladders, were hystologically examinated. Sixty-four of the 179 consecutive cholecystomized patients had typical adenomyomatosis. Thirty-eight of the 64 patients with adenomyomatosis had black pigment gallstones, alone (n ¼ 22) or in association with single (n ¼ 12) or multiple (n ¼ 4) cholesterol gallstones in the same gallbladder. Twelve of these patients did not have the typical risk factors for black stones (hemolysis, cirrhoses, gastrectomy, etc). Gallstones were examined by infrared spectroscopy and X-ray diffractometry. In addition, in a subset of 14 patients, the gallstones and the gallbladder wall were examined by scanning electron microscopy. At least in the initial phases of formation, Rokitansky-Aschoff Sinuses were found close to small intraparietal vessels and sometimes they contained black pigment microstones. After the fourth to fifth decades of life, black gallstones can be found in the Rokitansky-Aschoff Sinuses and in the main gallbladder lumen. Black pigment gallstones can form in Rokitansky-Aschoff Sinuses of the gallbladder in absence of the typical risk factors for bilirubin suprasaturation of bile.
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Black pigment gallstones with cholesterol gallstones in the same gallbladder : 13 cases in a surgical series of 1226 patients with gallbladder stones
Digestive diseases and sciences, 1995Co-Authors: Francesco Cetta, F Lombardo, Peter F. MaletAbstract:We studied 1312 consecutive patients who underwent surgery for gallstones in the biliary tract at one university hospital in Siena, Italy, with a systematic classification of gallstones found within the gallbladder. Of these patients, 1226 were found to have gallbladder stones; 94 of these had black pigment gallstones. Of these, 13 patients were found to have black pigment gallstones and cholesterol gallstones within their gallbladder. They all had multiple black pigment gallstones, usually very small (all < 6 mm diameter), in association with larger cholesterol stones in the gallbladder lumen. The cholesterol gallstones were single in seven cases, double in two cases, and multiple in four cases. All 13 of these patients with black pigment stones in association with cholesterol stones had histologic evidence of either adenomyomatosis or Rokitansky-Aschoff Sinuses in the gallbladder wall. In nine of the 13 patients, the black pigment stones were located both in the gallbladder lumen and in close association with the gallbladder wall (in areas of adenomyomatosis or in Rokitanski-Aschoff Sinuses). In the other four patients, the stones were found in close association with the gallbladder wall alone and not freely mobile within the gallbladder lumen. It is concluded that cholesterol stones and black pigment stones may be found in the same gallbladder. This association is infrequent with an incidence of 13 of 1226 (1.06%) in our series. There appears to be some relationship between the formation of the black pigment stones and the presence of adenomyomatosis or Rokitanski-Aschoff Sinuses.(ABSTRACT TRUNCATED AT 250 WORDS)
Kengo Yoshimitsu - One of the best experts on this subject based on the ideXlab platform.
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Well-differentiated adenocarcinoma of the gallbladder with intratumoral cystic components due to abundant mucin production: a mimicker of adenomyomatosis
European Radiology, 2005Co-Authors: Kengo Yoshimitsu, Kunishige Matake, Kouji Yamaguchi, Hitoshi Aibe, Yoshiki Asayama, Hiroyuki Irie, Tsuyoshi Tajima, Shuji Matsuura, Akihiro Nishie, Hiroshi HondaAbstract:The prevalence and etiology of the cystic components within gallbladder carcinomas as seen on MR images were evaluated. A retrospective review of MR images was performed for 35 proven gallbladder carcinomas in search of radiologically detectable intratumoral cystic components. The pathologic specimens were meticulously reviewed to determine the etiology. MR images of 31 adenomyomatoses were also reviewed for comparison to clarify the difference in MR features between these two entities. Three cases out of 35 proven gallbladder carcinomas were found to have intratumoral cystic components. They were all well-differentiated adenocarcinomas, and the cystic components consisted of dilated neoplastic glands filled with abundant mucin pool. Adenomyomatosis tended to have more and rounded cystic components (Rokitansky-Aschoff Sinuses) lined in a linear fashion and were flat-elevated in shape, smaller in size and had a regular surface, as compared to the three carcinomas. Although rare, radiologists need to be aware that well-differentiated gallbladder carcinoma with mucin production can have cystic components, which may mimic adenomyomatosis. Careful interpretation of MR images may provide useful information in the differentiation of these two entities.
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mr diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma importance of showing rokitansky aschoff Sinuses
American Journal of Roentgenology, 1999Co-Authors: Kengo Yoshimitsu, Makiko Jimi, Takao Kuroiwa, Kiyohiko Hanada, Hiroyuki Irie, Tsuyoshi Tajima, Kazuo Chijiiwa, Hiroshi Honda, M. Takashima, Mitsuo ShimadaAbstract:We evaluated the MR imaging features of adenomyomatosis of the gallbladder with particular emphasis on Rokitansky-Aschoff Sinuses.MR images of 17 patients with histologically proven adenomyomatosis were retrospectively reviewed. The presence of Rokitansky-Aschoff Sinuses was evaluated and analyzed; four T2-weighted (fast spin-echo with a surface coil, with or without breath-holding, fast spin-echo with a phased-array coil with breath-holding, and half-Fourier rapid acquisition with relaxation enhancement with breath-holding) and two contrast-enhanced dynamic pulse sequences were studied. These six pulse sequences were separately rated on a 5-point scale by two radiologists for comparison. Interobserver differences were evaluated. Other MR findings were also analyzed.Among the six pulse sequences studied, three T2-weighted with breath-holding sequences were found to be superior to the other three sequences in showing Rokitansky-Aschoff Sinuses. In particular, the half-Fourier rapid acquisition with relaxat...
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MR diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma: importance of showing Rokitansky-Aschoff Sinuses.
AJR. American journal of roentgenology, 1999Co-Authors: Kengo Yoshimitsu, Makiko Jimi, Takao Kuroiwa, Kiyohiko Hanada, Hiroyuki Irie, Tsuyoshi Tajima, Kazuo Chijiiwa, Hiroshi Honda, M. Takashima, Mitsuo ShimadaAbstract:We evaluated the MR imaging features of adenomyomatosis of the gallbladder with particular emphasis on Rokitansky-Aschoff Sinuses. MR images of 17 patients with histologically proven adenomyomatosis were retrospectively reviewed. The presence of Rokitansky-Aschoff Sinuses was evaluated and analyzed; four T2-weighted (fast spin-echo with a surface coil, with or without breath-holding, fast spin-echo with a phased-array coil with breath-holding, and half-Fourier rapid acquisition with relaxation enhancement with breath-holding) and two contrast-enhanced dynamic pulse sequences were studied. These six pulse sequences were separately rated on a 5-point scale by two radiologists for comparison. Interobserver differences were evaluated. Other MR findings were also analyzed. Among the six pulse sequences studied, three T2-weighted with breath-holding sequences were found to be superior to the other three sequences in showing Rokitansky-Aschoff Sinuses. In particular, the half-Fourier rapid acquisition with relaxation enhancement was scored the highest by the two observers and received the highest kappa coefficient in our statistical analysis of the scoring. Diffuse-type adenomyomatosis typically showed early mucosal and subsequent serosal enhancement. Localized adenomyomatosis exhibited homogeneous enhancement, showing smooth continuity with the surrounding gallbladder epithelium. MR imaging may be able to provide important information in the diagnosis of adenomyomatosis.
Hiroshi Honda - One of the best experts on this subject based on the ideXlab platform.
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Well-differentiated adenocarcinoma of the gallbladder with intratumoral cystic components due to abundant mucin production: a mimicker of adenomyomatosis
European Radiology, 2005Co-Authors: Kengo Yoshimitsu, Kunishige Matake, Kouji Yamaguchi, Hitoshi Aibe, Yoshiki Asayama, Hiroyuki Irie, Tsuyoshi Tajima, Shuji Matsuura, Akihiro Nishie, Hiroshi HondaAbstract:The prevalence and etiology of the cystic components within gallbladder carcinomas as seen on MR images were evaluated. A retrospective review of MR images was performed for 35 proven gallbladder carcinomas in search of radiologically detectable intratumoral cystic components. The pathologic specimens were meticulously reviewed to determine the etiology. MR images of 31 adenomyomatoses were also reviewed for comparison to clarify the difference in MR features between these two entities. Three cases out of 35 proven gallbladder carcinomas were found to have intratumoral cystic components. They were all well-differentiated adenocarcinomas, and the cystic components consisted of dilated neoplastic glands filled with abundant mucin pool. Adenomyomatosis tended to have more and rounded cystic components (Rokitansky-Aschoff Sinuses) lined in a linear fashion and were flat-elevated in shape, smaller in size and had a regular surface, as compared to the three carcinomas. Although rare, radiologists need to be aware that well-differentiated gallbladder carcinoma with mucin production can have cystic components, which may mimic adenomyomatosis. Careful interpretation of MR images may provide useful information in the differentiation of these two entities.
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mr diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma importance of showing rokitansky aschoff Sinuses
American Journal of Roentgenology, 1999Co-Authors: Kengo Yoshimitsu, Makiko Jimi, Takao Kuroiwa, Kiyohiko Hanada, Hiroyuki Irie, Tsuyoshi Tajima, Kazuo Chijiiwa, Hiroshi Honda, M. Takashima, Mitsuo ShimadaAbstract:We evaluated the MR imaging features of adenomyomatosis of the gallbladder with particular emphasis on Rokitansky-Aschoff Sinuses.MR images of 17 patients with histologically proven adenomyomatosis were retrospectively reviewed. The presence of Rokitansky-Aschoff Sinuses was evaluated and analyzed; four T2-weighted (fast spin-echo with a surface coil, with or without breath-holding, fast spin-echo with a phased-array coil with breath-holding, and half-Fourier rapid acquisition with relaxation enhancement with breath-holding) and two contrast-enhanced dynamic pulse sequences were studied. These six pulse sequences were separately rated on a 5-point scale by two radiologists for comparison. Interobserver differences were evaluated. Other MR findings were also analyzed.Among the six pulse sequences studied, three T2-weighted with breath-holding sequences were found to be superior to the other three sequences in showing Rokitansky-Aschoff Sinuses. In particular, the half-Fourier rapid acquisition with relaxat...
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MR diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma: importance of showing Rokitansky-Aschoff Sinuses.
AJR. American journal of roentgenology, 1999Co-Authors: Kengo Yoshimitsu, Makiko Jimi, Takao Kuroiwa, Kiyohiko Hanada, Hiroyuki Irie, Tsuyoshi Tajima, Kazuo Chijiiwa, Hiroshi Honda, M. Takashima, Mitsuo ShimadaAbstract:We evaluated the MR imaging features of adenomyomatosis of the gallbladder with particular emphasis on Rokitansky-Aschoff Sinuses. MR images of 17 patients with histologically proven adenomyomatosis were retrospectively reviewed. The presence of Rokitansky-Aschoff Sinuses was evaluated and analyzed; four T2-weighted (fast spin-echo with a surface coil, with or without breath-holding, fast spin-echo with a phased-array coil with breath-holding, and half-Fourier rapid acquisition with relaxation enhancement with breath-holding) and two contrast-enhanced dynamic pulse sequences were studied. These six pulse sequences were separately rated on a 5-point scale by two radiologists for comparison. Interobserver differences were evaluated. Other MR findings were also analyzed. Among the six pulse sequences studied, three T2-weighted with breath-holding sequences were found to be superior to the other three sequences in showing Rokitansky-Aschoff Sinuses. In particular, the half-Fourier rapid acquisition with relaxation enhancement was scored the highest by the two observers and received the highest kappa coefficient in our statistical analysis of the scoring. Diffuse-type adenomyomatosis typically showed early mucosal and subsequent serosal enhancement. Localized adenomyomatosis exhibited homogeneous enhancement, showing smooth continuity with the surrounding gallbladder epithelium. MR imaging may be able to provide important information in the diagnosis of adenomyomatosis.
