Differential diagnosis of gallbladder carcinoma and benign gallbladder diseases

Abstract

It is often difficult to distinguish gallbladder carcinoma from benign gallbladder diseases with thickened walls including chronic cholecystitis, xanthogranulomatous cholecystitis, gallbladder adenomyomatosis, and hyperplasia with a pancreatobiliary maljunction. US, CT, EUS, and MRI play important roles in the differential diagnosis between these benign gallbladder diseases and gallbladder carcinoma. In thickened gallbladder wall cases with inflammation or elevated serum CA19-9, it is sometimes difficult to distinguish gallbladder carcinoma and benign diseases. In these cases, the method of bile cytology using endoscopic naso-gallbladder drainage (ENGBD), or the cytology using EUS guided fine needle aspiration (EUS-FNA) may be useful for differential diagnosis. In the future, further studies will be needed to establish standard methods of ENGBD and EUS-FNA in gallbladder diseases with thickened walls.