Diagnosis of Gall Bladder Cancer
Gall Bladder Cancer Diagnosis: Book Excerpts
Diagnostic Tests for Gall Bladder Cancer: Online Medical Books
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Gallbladder and bile duct cancer:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
No test or procedure, by itself, can diagnose gallbladder cancer. However, the following laboratory tests support the diagnosis when they suggest hepatic dysfunction and extrahepatic biliary obstruction:
❑baseline studies — complete blood count, routine urinalysis, electrolyte studies, enzymes
❑ liver function tests — typically reveal elevated serum bilirubin, urine bile and bilirubin, and urobilinogen levels in more than 50% of patients as well as consistently elevated serum alkaline phosphatase levels
❑ occult blood in stools — linked to the associated anemia
❑ cholecystography — may show calculi or calcification
❑ cholangiography — may locate the site of common duct obstruction
❑ magnetic resonance imaging — detects tumors.
The following tests help compile data that confirm extrahepatic bile duct cancer:
❑ liver function studies — indicate biliary obstruction: elevated levels of bilirubin [5 to 30 mg/dl], alkaline phosphatase, and blood cholesterol as well as prolonged prothrombin time
❑ endoscopic retrograde cannulization of the pancreas — identifies the tumor site and allows access for obtaining a biopsy specimen.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Introduction: Malignant Neoplasms:
Diagnostic methods
(Professional Guide to Diseases (Eighth Edition))
A thorough medical history and physical examination should precede sophisticated diagnostic procedures. Useful tests for the early detection and staging of tumors include X-ray, endoscopy, isotope scan, computed tomography scan, and magnetic resonance imaging, but the single most important diagnostic tool is a biopsy for direct histologic study of tumor tissue. Biopsy tissue samples can be taken by curettage, fluid aspiration (pleural effusion), fine-needle aspiration biopsy (breast), dermal punch (skin or mouth), endoscopy (rectal polyps), and surgical excision (visceral tumors and nodes).
An important tumor marker, carcinoembryonic antigen (CEA), although not diagnostic by itself, can signal malignancies of the large bowel, stomach, pancreas, lungs, and breasts. CEA titers range from normal (less than 5 ng) to suspicious (5 to 10 ng) to suspect (over 10 ng). CEA serves many valuable purposes:
❑as a baseline during chemotherapy to evaluate the extent of tumor spread
❑to regulate drug dosage
❑to prognosticate after surgery or radiation
❑to detect tumor recurrence.
Although no more specific than CEA, alpha-fetoprotein — a fetal antigen uncommon in adults — can suggest testicular, ovarian, gastric, and hepatocellular cancers. Beta human chorionic gonadotropin may point to testicular cancer or choriocarcinoma. Other commonly used tumor markers include prostate-specific antigen to detect and monitor prostatic cancer, and CA-125, useful for monitoring ovarian, colorectal, and gastric cancers.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Malignant spinal neoplasms:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
❑Spinal and lumbosacral magnetic resonance imaging confirm spinal tumor.
❑ X-rays show distortions of the intervertebral foramina; changes in the vertebrae or collapsed areas in the vertebral body; and localized enlargement of the spinal canal, indicating an adjacent block.
❑ Myelography identifies the level of the lesion by outlining it if the tumor is causing partial obstruction; it shows anatomic relationship to the cord and the dura. If obstruction is complete, the injected dye can't flow past the tumor. (This study is dangerous if cord compression is nearly complete because withdrawal or escape of cerebrospinal fluid (CSF) will allow the tumor to exert greater pressure against the cord.)
❑ Radioisotope bone scan demonstrates metastatic invasion of the vertebrae by showing a characteristic increase in osteoblastic activity.
❑ Computed tomography scan shows cord compression and tumor location.
❑ Frozen section biopsy at surgery identifies the tissue type.
❑ Lumbar puncture may be normal, abnormal, or nonspecific. It may show clear yellow CSF as a result of increased protein levels if the flow is completely blocked. If the flow is partially blocked, protein levels rise, but the fluid is only slightly yellow in proportion to the CSF protein level. Cytology of the CSF may show malignant cells of metastatic carcinoma.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Bladder cancer:
Diagnosis
(Professional Guide to Diseases (Eighth Edition))
CONFIRMING DIAGNOSIS Only cystoscopy and biopsy confirm bladder cancer. Cystoscopy should be performed when hematuria first appears. When it's performed under anesthesia, a bimanual examination is usually done to determine if the bladder is fixed to the pelvic wall. A thorough history and physical examination may help determine whether the tumor has invaded the prostate or the lymph nodes. (See Comparing staging systems for bladder cancer.)
The following tests can provide essential information about the tumor:
❑Urinalysis can detect blood in the urine and malignant cytology.
❑ Excretory urography can identify a large, early stage tumor or an infiltrating tumor, delineate functional problems in the upper urinary tract, assess hydronephrosis, and detect rigid deformity of the bladder wall.
❑ Retrograde cystography evaluates bladder structure and integrity. Test results help to confirm the diagnosis.
❑ Pelvic arteriography can reveal tumor invasion into the bladder wall.
❑ Computed tomography scan reveals the thickness of the involved bladder wall and detects enlarged retroperitoneal lymph nodes.
❑ Ultrasonography can detect metastasis beyond the bladder and can distinguish a bladder cyst from a tumor.
❑ Excretory urography evaluates the upper urinary tract for tumors or blockage.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Gallbladder and bile duct cancers:
Diagnosis
(Handbook of Diseases)
No test or procedure is in itself diagnostic of gallbladder cancer. However, the following laboratory tests support this diagnosis when they suggest hepatic dysfunction and extrahepatic biliary obstruction:
❑ baseline studies (complete blood count, routine urinalysis, electrolyte studies, enzymes)
❑ liver function tests (typically reveal elevated serum bilirubin, urine bile and bilirubin, and urobilinogen levels in more than 50% of patients as well as consistently elevated serum alkaline phosphatase levels)
❑ occult blood in stools (linked to the associated anemia)
❑ cholecystography (may show stones or calcification)
❑ cholangiography (may locate the site of common duct obstruction)
❑ magnetic resonance imaging (detects tumors).
The following tests help compile data that confirm extrahepatic bile duct cancer:
❑ liver function tests (indicate biliary obstruction: elevated levels of bilirubin [5 to 30 mg/dl], alkaline phosphatase, and blood cholesterol as well as prolonged prothrombin time)
❑ endoscopic retrograde pancreatography (identifies the tumor site and allows access for obtaining a biopsy specimen).
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Bladder cancer:
Diagnosis
(Handbook of Diseases)
Only cystoscopy and a biopsy can confirm bladder cancer. Cystoscopy should be performed when hematuria first appears. When it’s performed under anesthesia, a bimanual examination is usually done to determine if the bladder is fixed to the pelvic wall. A thorough history and physical examination may help determine whether the tumor has invaded the prostate or the lymph nodes.
The following tests can provide essential information about the tumor:
❑ Urinalysis can detect blood in the urine and malignant cytology.
❑ Excretory urography can identify a large, early-stage tumor or an infiltrating tumor, delineate functional problems in the upper urinary tract, assess hydronephrosis, and detect rigid deformity of the bladder wall.
❑ Retrograde cystography evaluates bladder structure and integrity. Test results help to confirm the diagnosis.
❑ Pelvic arteriography can reveal tumor invasion into the bladder wall.
❑ Computed tomography scan reveals the thickness of the involved bladder wall and detects enlarged retroperitoneal lymph nodes.
❑ Ultrasonography can detect metastasis beyond the bladder and can distinguish a bladder cyst from a tumor.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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