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CT Findings of Gallbladder Metastases: Emphasis on Differences According to Primary Tumors

  • Choi, Won Seok (Department of Radiology, Seoul National University Hospital) ;
  • Kim, Se Hyung (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Eun Sun (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Kyoung-Bun (Department of Pathology, Seoul National University Hospital) ;
  • Yoon, Won Jae (Department of Internal Medicine, Inje University Seoul Paik Hospital, Inje University College of Medicine) ;
  • Shin, Cheong-Il (Department of Radiology, Seoul National University Hospital) ;
  • Han, Joon Koo (Department of Radiology, Seoul National University Hospital)
  • 투고 : 2013.11.11
  • 심사 : 2014.03.15
  • 발행 : 2014.06.01

초록

Objective: To describe computed tomography (CT) features of metastatic gallbladder (GB) tumors (MGTs) from various primary tumors and to determine whether there are differential imaging features of MGTs according to different primary tumors. Materials and Methods: Twenty-one patients who had pathologically confirmed MGTs and underwent CT were retrospectively enrolled. Clinical findings including presenting symptoms, type of surgery, and interval between primary and metastatic tumors were recorded. Histologic features of primary tumor and MGTs including depth of invasion were also reviewed. Imaging findings were analyzed for the location and morphology of MGTs, pattern and degree of enhancement, depth of invasion, presence of intact overlying mucosa, and concordance between imaging features of primary and metastatic tumors. Significant differences between the histologies of MGTs and imaging features were determined. Results: The most common primary tumor metastasized to the GB was gastric cancer (n = 8), followed by renal cell carcinoma (n = 4) and hepatocellular carcinoma (n = 3). All MGTs (n = 21) manifested as infiltrative wall thickenings (n = 15) or as polypoid lesions (n = 6) on CT, similar to the features of primary GB cancers. There were significant differences in the morphology of MGTs, enhancement pattern, enhancement degree, and depth of invasion according to the histology of primary tumors (p < 0.05). Metastatic adenocarcinomas of the GB manifested as infiltrative and persistently enhancing wall thickenings, while non-adenocarcinomatous metastases usually manifested as polypoid lesions with early wash-in and wash-out. Conclusion: Although CT findings of MGTs are similar to those of primary GB cancer, they are significantly different between the various histologies of primary tumors.

키워드

과제정보

연구 과제 주관 기관 : Seoul National University Hospital

참고문헌

  1. Yoon WJ, Yoon YB, Kim YJ, Ryu JK, Kim YT. Metastasis to the gallbladder: a single-center experience of 20 cases in South Korea. World J Gastroenterol 2009;15:4806-4809 https://doi.org/10.3748/wjg.15.4806
  2. Rehani B, Strohmeyer P, Jacobs M, Mantil J. Gallbladder metastasis from malignant melanoma: diagnosis with FDG PET/CT. Clin Nucl Med 2006;31:812-813 https://doi.org/10.1097/01.rlu.0000246860.97977.e1
  3. Guida M, Cramarossa A, Gentile A, Benvestito S, De Fazio M, Sanbiasi D, et al. Metastatic malignant melanoma of the gallbladder: a case report and review of the literature. Melanoma Res 2002;12:619-625 https://doi.org/10.1097/00008390-200212000-00012
  4. Vernadakis S, Rallis G, Danias N, Serafimidis C, Christodoulou E, Troullinakis M, et al. Metastatic melanoma of the gallbladder: an unusual clinical presentation of acute cholecystitis. World J Gastroenterol 2009;15:3434-3436 https://doi.org/10.3748/wjg.15.3434
  5. Ghaouti M, Znati K, Jahid A, Zouaidia F, Bernoussi Z, El Fakir Y, et al. A gallbladder tumor revealing metastatic clear cell renal carcinoma: report of case and review of literature. Diagn Pathol 2013;8:4 https://doi.org/10.1186/1746-1596-8-4
  6. Chung PH, Srinivasan R, Linehan WM, Pinto PA, Bratslavsky G. Renal cell carcinoma with metastases to the gallbladder: four cases from the National Cancer Institute (NCI) and review of the literature. Urol Oncol 2012;30:476-481 https://doi.org/10.1016/j.urolonc.2010.04.010
  7. Nojima H, Cho A, Yamamoto H, Nagata M, Takiguchi N, Kainuma O, et al. Renal cell carcinoma with unusual metastasis to the gallbladder. J Hepatobiliary Pancreat Surg 2008;15:209-212 https://doi.org/10.1007/s00534-007-1226-5
  8. Backman H. Metastases of malignant melanoma in the gastrointestinal tract. Geriatrics 1969;24:112-120
  9. Barretta ML, Catalano O, Setola SV, Granata V, Marone U, D'Errico Gallipoli A. Gallbladder metastasis: spectrum of imaging findings. Abdom Imaging 2011;36:729-734 https://doi.org/10.1007/s00261-011-9696-y
  10. Kim SY, Kim KW, Kim AY, Ha HK, Kim JS, Park SH, et al. Bloodborne metastatic tumors to the gastrointestinal tract: CT findings with clinicopathologic correlation. AJR Am J Roentgenol 2006;186:1618-1626 https://doi.org/10.2214/AJR.05.0095
  11. Yoshimitsu K, Honda H, Shinozaki K, Aibe H, Kuroiwa T, Irie H, et al. Helical CT of the local spread of carcinoma of the gallbladder: evaluation according to the TNM system in patients who underwent surgical resection. AJR Am J Roentgenol 2002;179:423-428 https://doi.org/10.2214/ajr.179.2.1790423
  12. Kim SJ, Lee JM, Lee JY, Choi JY, Kim SH, Han JK, et al. Accuracy of preoperative T-staging of gallbladder carcinoma using MDCT. AJR Am J Roentgenol 2008;190:74-80 https://doi.org/10.2214/AJR.07.2348
  13. Horton KM, Fishman EK. Current role of CT in imaging of the stomach. Radiographics 2003;23:75-87 https://doi.org/10.1148/rg.231025071
  14. Scatarige JC, DiSantis DJ. CT of the stomach and duodenum. Radiol Clin North Am 1989;27:687-706
  15. Jin KN, Lee JM, Kim SH, Shin KS, Lee JY, Han JK, et al. The diagnostic value of multiplanar reconstruction on MDCT colonography for the preoperative staging of colorectal cancer. Eur Radiol 2006;16:2284-2291 https://doi.org/10.1007/s00330-006-0316-0
  16. Lee JH, Lee JM, Kim SJ, Baek JH, Yun SH, Kim KW, et al. Enhancement patterns of hepatocellular carcinomas on multiphasicmultidetector row CT: comparison with pathological differentiation. Br J Radiol 2012;85:e573-e583 https://doi.org/10.1259/bjr/86767895
  17. Lee JM, Choi BI. Hepatocellular nodules in liver cirrhosis: MR evaluation. Abdom Imaging 2011;36:282-289 https://doi.org/10.1007/s00261-011-9692-2
  18. Sun MR, Ngo L, Genega EM, Atkins MB, Finn ME, Rofsky NM, et al. Renal cell carcinoma: dynamic contrast-enhanced MR imaging for differentiation of tumor subtypes--correlation with pathologic findings. Radiology 2009;250:793-802 https://doi.org/10.1148/radiol.2503080995
  19. Levy AD, Murakata LA, Rohrmann CA Jr. Gallbladder carcinoma: radiologic-pathologic correlation. Radiographics 2001;21:295-314; questionnaire, 549-555 https://doi.org/10.1148/radiographics.21.2.g01mr16295
  20. Lane J, Buck JL, Zeman RK. Primary carcinoma of the gallbladder: a pictorial essay. Radiographics 1989;9:209-228 https://doi.org/10.1148/radiographics.9.2.2648501
  21. Ishiguro S, Onaya H, Esaki M, Kosuge T, Hiraoka N, Mizuguchi Y, et al. Mucin-producing carcinoma of the gallbladder: evaluation by magnetic resonance cholangiopancreatography in three cases. Korean J Radiol 2012;13:637-642 https://doi.org/10.3348/kjr.2012.13.5.637
  22. Westacott SM, Mahraj R. Anatomy and imaging of the normal gallbladder. In: Meilstrup JW, ed. Imaging atlas of the normal gallbladder and its variants. Boca Raton: CRC Press, 1994:4
  23. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, et al. AJCC Cancer Staging Manual, 7th ed. New York: Springer-Verlag, 2010:211-217
  24. Jang JY, Kim SW, Lee SE, Hwang DW, Kim EJ, Lee JY, et al. Differential diagnostic and staging accuracies of high resolution ultrasonography, endoscopic ultrasonography, and multidetector computed tomography for gallbladder polypoid lesions and gallbladder cancer. Ann Surg 2009;250:943-949 https://doi.org/10.1097/SLA.0b013e3181b5d5fc
  25. Jung SE, Lee JM, Lee K, Rha SE, Choi BG, Kim EK, et al. Gallbladder wall thickening: MR imaging and pathologic correlation with emphasis on layered pattern. Eur Radiol 2005;15:694-701 https://doi.org/10.1007/s00330-004-2539-2

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