Intracholecystic papillary-tubular neoplasm in a patient with choledochal cyst and anomalous pancreaticobiliary junction: case report

A 75-year-old female incidentally presented with an enhancing intraluminal gallbladder mass, main bile duct dilatation and anomalous pancreaticobiliary junction (APBJ) during the staging of gastric adenocarcinoma. Histopathological analysis confirmed the diagnosis of intracholecystic papillary-tubular neoplasm. Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder are rare gallbladder neoplasms, defined as intramucosal, preinvasive, exophytic, mass forming lesions. An association between choledochal cysts and anomalous pancreaticobiliary junction with gallbladder neoplasms is well known, and this case potentially illustrates gallbladder carcinogenesis related to these biliary anomalies.

Adenoma of the gallbladder in a mongoose (Mungos mungo)

ABSTRACT: Primary gallbladder neoplasms occur infrequently in domestic animals and rarely in wild animals. This article describes a case of gallbladder adenoma in a mongoose ( Mungos mungo) in captivity. Grossly, the gallbladder was moderately distended with a smooth capsular surface. Necropsy showed an irregular, soft, whitish nodule 0.8cm in diameter. Microscopic examination of the nodule showed proliferation of epithelial cells, which projected from the mucosa and formed papillary projections supported by a sparse fibrovascular stroma. Neoplastic cells were well differentiated with mild anisocytosis and anisokaryosis. Based on these histopathological findings, adenoma of the gallbladder was diagnosed.

A Longitudinal Computed Tomography Imaging in the Diagnosis of Gallbladder Cancer

Background/Aim. To assess whether the diagnostic power of longitudinal multiplanar reformat (MPR) images is superior to that of conventional horizontal images for gallbladder cancer (GBC).Methods.Between 2006 and 2010, a total of 54 consecutive patients with preoperatively diagnosed gallbladder neoplasms located in gallbladder bed were analyzed. These patients underwent cholecystectomy with resection of the adjacent liver parenchyma. The patients were divided into the GBC group (n=30) and the benign group (n=24). MPR images obtained by preoperative multidetector row CT (MDCT) were assessed.Results.Mucosal line was more significantly disrupted in GBC group than that in benign group (93% [28/30 patients] versus 13% [3/24],p<0.001). Maximum (9.3 [4.2–24.8] versus 7.0 mm [2.4–22.6],p=0.29) and minimum (1.2 [1.0–2.4] versus 1.3 mm [1.0–2.6],p=0.23) wall thicknesses on a single MPR plane did not differ significantly; however, the wall thickness ratio (max/min) differed significantly (6.8 [1.92–14.0] versus 5.83 [2.3–8.69],p=0.04). Partial liver enhancement adjacent to tumor on longitudinal images was more common in GBC (40.0% [12/30 patients] versus 12.5% [3/24],p=0.03). Mucosal line disruption was the most reliable independent predictor of diagnosis (odds ratio, 8.5; 95% CI, 5.99–28.1,p<0.001).Conclusion.Longitudinal MPR images are more useful than horizontal images for the diagnosis of GBC.