Carcinoma of Gallbladder Practice Flashcards

Critical vocabulary and concepts covering the epidemiology, risk factors, pathology, clinical management, and Ayurvedic correlations of gallbladder carcinoma.

Carcinoma of the gallbladder (GBC)

The most common malignancy of the biliary tract and the fifth most common cancer of the gastrointestinal tract, known for its aggressive biology and poor prognosis.

Gangetic belt

A region in Northern India identified as having a high geographic incidence of gallbladder carcinoma.

Female-to-male ratio in GBC

Approximately $3:1$, which is attributed to higher gallstone prevalence and the influence of estrogen.

Cholelithiasis risk factor

Present in $70–90\%$ of GBC patients; the risk increases specifically with a stone size $>3\,cm$ and long disease duration.

Porcelain gallbladder

Dystrophic calcification of the gallbladder wall, historically considered a high-risk condition for malignancy, especially with selective mucosal calcification.

Chronic Salmonella typhi carrier state

A condition where chronic biliary colonization promotes the formation of carcinogenic bile acid metabolites.

Anomalous pancreaticobiliary ductal junction

A structural variation that allows pancreatic juice to reflux into the biliary tree, acting as a risk factor for GBC.

Infiltrative gross type

The most common gross pathological pattern of GBC, characterized by diffuse wall thickening often mistaken for chronic cholecystitis.

Papillary adenocarcinoma

A subtype of adenocarcinoma comprising approximately $90\%$ of cases, noted for having the best prognosis among the histological types.

Liver segments IVb/V

The specific segments of the liver where GBC commonly spreads via direct invasion because the gallbladder lacks a well-developed serosa on the hepatic surface.

Courvoisier's sign

The clinical finding of a palpable, non-tender gallbladder accompanied by painless jaundice.

Ultrasonography (USG)

The first-line imaging modality for GBC, which may show focal/diffuse wall thickening $>1\,cm$ or an intraluminal mass.

Tumor markers

CA 19-9 and CEA, which are supportive rather than diagnostic and are primarily used for monitoring the disease.

Simple cholecystectomy

A surgical procedure that is adequate only for Tis or T1a disease where the cancer is confined to the mucosa.

Extended (radical) cholecystectomy

The mainstay treatment for T1b disease and beyond, including hepatic resection (segments IVb/V or wedge) and regional lymphadenectomy.

Gemcitabine-cisplatin

The standard first-line palliative chemotherapy regimen used for unresectable or metastatic gallbladder carcinoma.

Pittashaya

The Ayurvedic term for the gallbladder, often discussed in relation to the Yakrit (liver) rather than as a separate organ in classical Samhitas.

Arbuda and Granthi

Ayurvedic correlations for neoplasms or nodular swellings arising from vitiated Kapha-Meda dushti with Pitta-Rakta involvement.

Kamala

The Ayurvedic term for jaundice, which is often associated with the advanced stages of gallbladder pathology.

Pittashaya-ashmari

The Ayurvedic term for chronic gallstone disease, considered a pathway for persistent local Dosha-Dushya vitiation analogous to the gallstone-carcinoma sequence.