Excellent!! It is very basic, but essentially important!

We do not want to be a blindman touching only small part of a huge elephant.

Focal high-grade dysplasia is present.

Need to know the extension of the lesion.

Any involvement of the submucosa and beyond?

If it is confied within the muscularis mucosae, it is at most an adenocarcinoma in-situ. TNM stage: Tis, and the patient is cured.

If it invades to the submucosa and beyond, many times perineural invasion can be found.  The clinical outcome is very bad.

 建议把那个新生物处的胆囊壁全层取材，必要时将胆囊全部取材看看。

我也希望能见到大象的全身。呵呵。

It is an outstanding teaching case!

Most likeky, the patient was cured based on all the above information.

 谢谢各位老师

我们最终诊断：胆囊腺瘤，粘膜高级别上皮内瘤变。