Ultrasonographic Appearance of Gallbladder Neoplasia in 14 Dogs and 1 Cat

Alexandra N. MacLeod, Jean K. Reichle, David Szabo, Eli B. Cohen, Charles Artiles, Caroline V Fulkerson, Manabu Kurihara, John Mattoon

Background: Gallbladder neoplasia is a rare and poorly documented cause of extrahepatic biliary disease in dogs and cats. This study aims to describe the ultrasonographic appearance and diagnosis of gallbladder neoplasia with confirmed cases.

Study: This is a retrospective, multicenter, case series study that examines the ultrasound images and reports of 14 dogs and one cat with gallbladder neoplasia and a histologic or cytologic diagnosis.

Methods: The cases were collected from five institutions that responded to a request for patients with gallbladder neoplasia and ultrasound exams performed by certified veterinary radiologists. The ultrasound images were reviewed by two ACVR-certified veterinary radiologists and the signalment, clinical signs, bloodwork, and surgical or necropsy reports were cataloged.

Results: The most common gallbladder neoplasm was neuroendocrine carcinoma, followed by leiomyoma. The masses had variable sonographic appearances in terms of size, shape, echogenicity, location, and gallbladder wall thickening. All discrete masses were sessile in shape and all studies with Doppler images showed vascularity. Cholecystoliths were uncommon and only one case had distant metastasis. Gallbladder neoplasia was not always associated with clinical signs or abnormal bloodwork.

Limitations: The study was limited by the small sample size, the lack of a control group, the variability in ultrasound machines and transducers, the lack of regional lymphadenopathy assessment, and the possible underrepresentation of masses with irregular appearances.

Conclusions: Gallbladder neoplasia should be considered as a differential diagnosis for dogs or cats with any of the variable ultrasonographic appearances described in this paper, and with or without clinical signs of hepatobiliary disease. No specific ultrasound features could differentiate the histopathologic type of gallbladder neoplasia. Doppler interrogation is recommended for distinguishing masses from inspissated bile or mucocele.

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