Rokitansky-Aschoff sinus
Tiny pouches where the gallbladder lining pushes down into the muscle wall, common in gallbladders damaged by stones and inflammation. They matter in cancer because an early tumour that tracks down into these pouches behaves worse than one that stays on the surface, and mucus trapped in them can be mistaken for cancer under the microscope.
Overview
Rokitansky-Aschoff sinuses are outpouchings of the gallbladder mucosa into and through the muscularis, frequent in chronic cholecystitis and the basis of adenomyomatosis. In a series of 190 early gallbladder carcinomas (Tis, T1a, T1b) from a high-incidence region, intraepithelial extension into the sinuses was present in 17.8 percent (34 cases); patients with sinus involvement had significantly shorter survival, 39 percent dying of disease against 4 percent without, often late (median 48 months), making it an independent adverse factor for which additional surgery may be considered (Roa 2013). The pitfall runs the other way too: mucin-containing sinuses with extracellular mucin deposits can simulate mucinous carcinoma (Albores-Saavedra 2009), and adenomyomatosis with intramural cysts can be confused with a papillary neoplasm on imaging. The sinuses are why depth measurements in early gallbladder cancer need care and why full sampling of the specimen is advised.
- Pancreatic head (most PDAC)
- Body and tail
- Ampulla
- Islets (pancreatic NET)
- Intrahepatic ducts
- Perihilar (Klatskin)
- Distal bile duct
- Gallbladder
- Nodes: peripancreatic
- Nodes: hepatic hilar
- Nodes: coeliac and superior mesenteric
Most pancreatic cancers arise in the head next to the bile duct, which is why jaundice is the presenting sign; bile duct cancers are named by where along the tree they sit.
- Pancreatic head (most PDAC)
- Body and tail
- Ampulla
- Islets (pancreatic NET)Neuroendocrine carcinoma of the gallbladder (small cell and large cell; under 5 percent)
- Intrahepatic ducts
- Perihilar (Klatskin)
- Distal bile duct
- GallbladderGallbladder adenocarcinoma (about 90 percent; biliary, intestinal, mucinous and other patterns) · Papillary carcinoma of the gallbladder, and its precursor the intracholecystic papillary neoplasm · Mucinous carcinoma of the gallbladder (about 2.5 percent) · Adenosquamous and squamous carcinoma of the gallbladder (about 5 percent) · Neuroendocrine carcinoma of the gallbladder (small cell and large cell; under 5 percent) · Incidental gallbladder cancer found in the cholecystectomy specimen · Carcinoma in situ and dysplasia of the gallbladder (biliary intraepithelial neoplasia; stage 0) · Cystic duct carcinoma (staged with gallbladder cancer)
- peripancreatic
- hepatic hilar
- coeliac and superior mesenteric
Same organ: Pancreatic ductal adenocarcinoma, Biliary tract cancer (cholangiocarcinoma), Intrahepatic cholangiocarcinoma, Extrahepatic cholangiocarcinoma (perihilar and distal), Biliary tract cancer (all types), Neuroendocrine tumours, Pancreatic neuroendocrine tumours, Grade 3 well-differentiated neuroendocrine tumour, Extrapulmonary neuroendocrine carcinoma, Gallbladder adenocarcinoma, Papillary carcinoma of the gallbladder, Mucinous carcinoma of the gallbladder, Adenosquamous and squamous carcinoma of the gallbladder, Neuroendocrine carcinoma of the gallbladder, Incidental gallbladder cancer (found after cholecystectomy), Carcinoma in situ and dysplasia of the gallbladder, Cystic duct carcinoma, Ampullary cancer (ampulla of Vater), Resectable pancreatic ductal adenocarcinoma, Borderline resectable pancreatic ductal adenocarcinoma, Locally advanced unresectable pancreatic ductal adenocarcinoma, Metastatic pancreatic ductal adenocarcinoma, KRAS G12C-mutant pancreatic ductal adenocarcinoma, KRAS wild-type pancreatic ductal adenocarcinoma, BRCA or PALB2-mutant pancreatic ductal adenocarcinoma, Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma, Pancreatic acinar cell carcinoma, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatoblastoma
Showing the organ this term concerns: Gallbladder cancer.
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