Macroscopy:  Labelled "Gallbladder". A gallbladder received unopened 70 x 40 mm (length × diameter) with a haemorrhagic, dull serosa, an irregularly thickened wall up to 10 mm, a haemorrhagic, and patchily polypoid/cobblestone mucosa, with a vague ovoid swelling 15 x 12 mm.  The lumen contains haemorrhagic material, and 2 green gallstones 11-15 mm.  There is a cholecystic lymph node 7mm. Black ink marks the margin immediately adjacent the proximal margin.

Microscopy: Gallbladder, shows surface columnar epithelium, focally showing dysplasia and also showing an area within which there is surface ulceration deep to which there are islands and glands of varying sizes lined by moderately pleomorphic epithelial cells, associated with reduction of mucin, infiltrating through the gallbladder wall and into the serosal tissues in association with a reactive inflammatory process. Focally, the tumour is seen to extend to the diathermy fatty tissues, surrounding the gallbladder wall lymphovascular invasion is seen. Tumour is also present in the connective tissues at the gallbladder neck. Adjacent gallbladder shows haemorrhage and reactive fibroblasts within the gallbladder wall in addition to this muscle hypertrophy. Lymph node shows sinus histiocytosis with no evidence of metastatic malignancy.

Conclusion:  Gallbladder – poorly differentiated adenocarcinoma of the gallbladder extending full thickness through the gallbladder wall through fatty tissues and present at a determined margin of the omental fatty tissue surrounding the gallbladder, the tumour is also present in the fat tissues of the proximal gallbladder neck. Lymphovascular invasion is seen. No involvement of the cholecystic lymph node (0/1). Adjacent gallbladder shows acute on chronic inflammation.  

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