Letter to the Editor: What are contrast-enhanced ultrasound criteria for T2 gallbladder carcinoma?

What is it about?

Contrast-enhanced ultrasound (CEUS) is useful for the differential diagnosis of a gallbladder tumor between malignancy and benignancy. However, its usefulness is doubtful in diagnosing the invasion depth of gallbladder carcinoma (GBC). In contrast, a comparative analysis between ultrasound and pathology is essential in diagnosing GBC, including invasion depth of carcinoma.

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Photo by Hans Veth on Unsplash

Photo by Hans Veth on Unsplash

Why is it important?

Hunt et al. present a polypoid T2 GBC and insist the GBC was definitely diagnosed utilizing CEUS. However, whether a deep hypoechoic area is present in the sonographic images is obscure. Then, unfortunately, they do neither disclose the loupe view of the case nor contrast-enhanced ultrasound criteria for T2 GBC. Generally, histopathology reveals a polypoid T2 GBC consisting of a superficial well-differentiated adenocarcinoma and a deep, moderately to poorly differentiated adenocarcinoma invading subserosa accompanied by abundant fibrosis and lymphocytic infiltration. In addition, ultrasound and pathological correlation show that a superficial hyperechoic part coincides with a papillary adenocarcinoma and a deep hypoechoic area represents an adenocarcinoma invading subserosa accompanied by abundant fibrosis and lymphocytic infiltration, except in scarce circumstances.

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