Biliary Metastases and Lymphoma
Michael P. Federle, MD, FACR
Brooke R. Jeffrey, MD
Key Facts
Terminology
-
Metastatic deposits involving gallbladder (GB) or bile duct (BD) wall
Imaging
-
Best diagnostic clue: Polypoid GB mass > 1.5 cm in patient with known melanoma
-
Ultrasound for initial diagnosis
-
CECT or MR for global view of abdomen
-
-
Morphology
-
Metastases: Polypoid mass in GB wall; BD wall mass causing luminal obstruction
-
Lymphoma: Bulky GB & porta hepatis mass with generalized lymphadenopathy
-
Top Differential Diagnoses
-
Benign intramural gallbladder polyp
-
Gallbladder carcinoma
-
Adenomyomatosis
Pathology
-
Lymphoma
-
Most cases are non-Hodgkin lymphoma (NHL)
-
-
Metastases
-
Melanoma is most common primary tumor
-
Renal cell & other cancers have been reported
-
Clinical Issues
-
Most patients are asymptomatic
-
Lesions usually discovered as part of CT staging
-
RUQ pain or jaundice may result from BD metastases; rarely from lymphoma
-
-
Metastases carry poor prognosis; usually part of widespread & advanced disease
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
