The document describes various benign and malignant pathologies of the gallbladder and biliary tract that can be identified on imaging. It discusses conditions such as gangrenous cholecystitis, porcelain gallbladder, gallbladder perforation, adenomyomatosis, gallbladder polyps, and gallbladder carcinoma. It also reviews benign tumors of the biliary tract such as adenomas. Malignant neoplasms covered include intrahepatic and hilar cholangiocarcinomas, as well as distal ductal cholangiocarcinomas. Imaging findings for differentiating these pathologies are presented.

1. Patología benigna y maligna
de vesícula biliar
R1CG Edgar Var gas Fl or es

2. Colecistitis gangrenosa
• Hemor r agi a i nt r amur al
• Necr osi s
• Mi cr oabscesos
• Debr i s i nt r al umi nal es
• Exudados f i br i nosos
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

3. Colecistitis gangrenosa
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

4. Colecistitis gangrenosa
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

5. Colecistitis gangrenosa
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

6. Colecistitis alitiásica
• Adul t os gr aves
• Vi scosi dad bi l i ar
• Necr osi s mur al
• Mor t al i dad
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

7. Colecistitis alitiásica
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

8. Colecistitis alitiásica
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

9. Colecistitis alitiásica
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

10. Colecistitis enfisematosa
• <1% de col eci st i t i s
• Di abét i cos 35%
• Cl o s t r i d i um s p , Kl e bs i e l l a
s p , E. Co l i .
• Ri esgo de per f or aci ón 5x
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

11. Colecistitis enfisematosa
http://www.stritch.luc.edu/lumen/MedEd/Radio/curriculum/Surgery/cho
lecystitis.htm

12. Colecistitis enfisematosa
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

13. Colecistitis enfisematosa
http://www.stritch.luc.edu/lumen/MedEd/Radio/curriculum/Surgery/cho
lecystitis.htm

14. Perforación vesicular
• 5 a 10% de col eci st i t i s
• Col eci st i t i s gangr enosa
• Fondo vesi cul ar
• Paci ent es t óxi cos
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

15. Perforación vesicular
http://www.ultrasoundcases.info/Slide-View.aspx?cat=165&case=3113

16. Perforación vesicular
http://www.ultrasoundcases.info/Slide-View.aspx?cat=165&case=3113

17. Perforación vesicular
http://www.ultrasoundcases.info/Slide-View.aspx?cat=165&case=3113

18. Vesícula en porcelana
• <1%
• Capa muscul ar , mucosa y/ o
submucosa
• 5x más f r ecuent e en hombr es
• 11- 33% Ca vesi cul ar .
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

19. Vesícula en porcelana
http://www.revise4finals.co.uk/cms/image-xray-menu/axrnoflash/view-
image/4f7f862df81f046ac762e1b98d0806d8/gif

20. Vesícula en porcelana
http://quizlet.com/9614492/fcm-gi-gb-pancreas-path-flash-cards/

21. Vesícula en porcelana
http://www.radiologyassistant.nl/en/p43a0746accc5d#i43dfe4da786f8

22. Vesícula en porcelana
http://www.radiologyassistant.nl/en/p43a0746accc5d#i43dfe4da786f8

23. Vesícula en porcelana
http://www.ultrasoundcases.info/Slide-View.aspx?cat=152&case=2977

24. Vesícula en porcelana
http://www.indianjcancer.com/viewimage.asp?
img=IndianJournalofCancer_2011_48_1_132_76646_u2.jpg

25. Adenomiomatosis
• Pr ol i f er aci ón epi t el i al con
hi per t r of i a muscul ar y
di ver t í cul os mucosos-
submucosos.
• Di f usa, segment ar i a y
Local i zada ( f ondo) .
• Nódul os de Roki t ansky
Aschof fGore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

26. Adenomiomatosis
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

27. Adenomiomatosis
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

28. Adenomiomatosis
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

29. Adenomiomatosis
http://radiology.rsna.org/content/227/1/80/F3.expansion.html

30. Pólipos
• Col est er ol : 5%,
adenomat osos: 0. 4%
• 0. 1 a 2. 5 cm de di ámet r o
• >1 cm: sospechar mal i gni dad
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

31. Pólipos
http://myradnotes.wordpress.com/2008/06/06/gallbladder-polyps/

32. Pólipos
http://myradnotes.wordpress.com/2008/06/06/gallbladder-polyps/

33. Pólipos
http://www.ultrasoundcases.info/Case-List.aspx?cat=167

34. Pólipos
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

35. Carcinoma vesicular
• 5ª GI más f r ecuent e
• 1- 3% de col eci st ect omí as
• Li t i asi s, col eci st i t i s cr óni ca
y vesí cul a en por cel ana.
• Muj er es
• 60- 70 años.
• DX di f í ci l y t ar dí o
• Sobr evi da a 5 años: <5%
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

36. Carcinoma vesicular
• 3 f or mas de pr esent aci ón
– Engr osami ent o de par ed f ocal
– Tumor i nt r al umi nal pol i poi de >2 cm
( 25%) .
– Tumor aci ón subhepát i ca ( 40- 65%)
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

37. Carcinoma vesicular
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

38. Carcinoma vesicular
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

39. Carcinoma vesicular
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

40. Carcinoma vesicular
Gore RM, Yaghmai V, Newmark G et al. Imaging benign and malignant disease of
the gallbladder. Radiol Clin N Am 40. 1307– 1323. Evanston, IL. 2002.

41. Neoplasias de vías biliares

42. Tumores benignos de vía biliar
• Rar os
• Adenoma de ví a bi l i ar
• Pequeños ( i nci dent al es)
• Def ect os de l l enado
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

43. Adenoma de vía biliar
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

44. Cistadenoma/Cistadenocarcinoma biliar
• I nt r ahepát i cos
• Muj er es de edad medi a
• Tumor aci ones gr andes
sol i t ar i as
• Tumor aci ones quí si t cas –
t umor aci ones nodul ar es
sept adas
• Cal ci f i caci ones f i nas o
i r r egul ar es abundant es
• Pr emal i gnosBarón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

45. Cistadenoma biliar hiliar
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

46. Cistadenoma biliar hiliar
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

47. Colangiocarcinoma
• Más común
• I nt r ahepát i cos ( 20- 30%)
• Semej an met ást asi s
• Hi l i ar es ( Kl at ski n) ( más
comunes)
• Conf l uenci a del hepát i co der echo o
i zqui er do
• USG. ” Vent ana hepàt i ca”
• Duct al es di st al es
• Menos común
• Mej or pr onóst i co
• USG
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

48. Colangiocarcinoma intrahepático
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

49. Colangiocarcinoma hiliar
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

50. Colangiocarcinoma hiliar
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

51. Colangiocarcinoma ductal distal
Barón RL, Tublin V, Peterson M. Imaging the spectrum of biliary tract
dsease. Radiol Clin N Am 40. 1325– 1743. Pittsburgh, PA. 2002.

52. Gracias