1/15. gallbladder adenomyomatosis presenting as fever of unknown origin: a case report.gallbladder adenomyomatosis is a rare disorder, characterized by benign hyperplasia of the gallbladder mucosa creating invaginations through the muscular layer, known as Rokitansky-Aschoff sinuses. It is considered an acquired disease, with pathophysiology similar to that of the diverticular disease of the colon. diagnosis is often achieved by ultrasound, but a significant percentage is misdiagnosed as chronic cholecystitis, whereas the diagnosis is finally achieved histologically. We describe a case of gallbladder adenomyomatosis presenting as fever of unknown origin. The patient was a 17-year-old girl with a history of sustained fever of 38.5 degrees C of two months' duration. There were no accompanying symptoms and the whole diagnostic workup, including abdominal ultrasound, was negative. gallbladder inflammation was evident during an eventual investigatory laparoscopy, and cholecystectomy was performed. The histologic results were consistent with diffuse adenomyomatosis. The patient became afebrile immediately after cholecystectomy. To our knowledge, fever has never been associated with gallbladder adenomyomatosis before in bibliography, nor has adenomyomatosis been mentioned as a cause of fever of unknown origin. We therefore believe that gallbladder adenomyomatosis should be considered in the differential diagnosis of sustained fever with negative workup.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/15. Fundic adenomyomatosis bulged with the subserosal excessive fat of the gallbladder mimicking polypoid carcinoma: a case report with unusual imaging and morphological features.This report describes a 41-year-old female who presented with adenomyomatosis of the gallbladder mimicking polypoid carcinoma, on the diagnostic imaging findings and revealing unusual histologic features for such a localized adenomyomatosis. The mass was located on the gallbladder liver-side wall at the fundus and papillary hyperechoic growth showed no clear ultrasonographic features of adenomyomatosis. The patient underwent a laparoscopic cholecystectomy with a tentative diagnosis of superficial polypoid carcinoma. Histologically, the tumor bulged due to subserosal excessive fat tissue.- - - - - - - - - - ranking = 1.5keywords = gallbladder (Clic here for more details about this article) |
3/15. Symptomatic adenomyomatosis of the gallbladder--report of a case.Adenomyomatosis of the gallbladder is a benign and degenerative condition of the gallbladder, characterized by proliferation of the mucosa of the gallbladder wall, forming invaginations and diverticula, penetrating a thickened muscular layer: the so-called Rokitansky-Aschoff sinuses (RAS). Most of the patients with adenomyomatosis remain asymptomatic. Hence adenomyomatosis is usually an incidental finding, either on ultrasonography performed for the detection of stones or by histologic examination of surgical gallbladder specimens. Only occasionally does adenomyomatosis not associated with cholelithiasis cause right upper quadrant pain. We report a case of symptomatic adenomyomatosis of the gallbladder. Clinical findings, etiology, diagnosis and therapy are discussed.- - - - - - - - - - ranking = 2.25keywords = gallbladder (Clic here for more details about this article) |
4/15. gallbladder polyps, cholesterolosis, adenomyomatosis, and acute acalculous cholecystitis.Acute acalculous cholecystitis is characterized by acute inflammation of the gallbladder in the absence of stones, usually occurring in elderly and critically ill patients with atherosclerosis, recent surgery or trauma, or hemodynamic instability. patients may present with only unexplained fever, leukocytosis, and hyperamylasemia without right upper quadrant tenderness. If untreated, rapid progression to gangrene and perforation occurs. Surgical cholecystectomy and cholecystostomy provide the most definitive treatment although recent studies indicate success with percutaneous or endoscopic cholecystostomy. Cholesterolosis and adenomyomatosis of the gallbladder are usually clinically silent and incidental findings at the time of cholecystectomy. Cholesterolosis is characterized by mucosal villous hyperplasia with excessive accumulation of cholesterol esters within epithelial macrophages. Usually clinically silent, the condition rarely is associated with biliary symptoms or idiopathic pancreatitis and cannot reliably be detected by ultrasonography. Adenomyomatosis describes an acquired, hyperplastic lesion of the gallbladder characterized by excessive proliferation of surface epithelium with invaginations into a thickened muscularis propria. ultrasonography may reveal a thickened gallbladder wall with intramural diverticula. Adenomyomatosis may portend a higher risk of gallbladder malignancy. Most cases of cholesterolosis and adenomyomatosis identified by imaging require no specific treatment. gallbladder polyps include all mucosal projections into the gallbladder lumen and include cholesterol polyps, adenomyomas, inflammatory polyps, adenomas, and other miscellaneous polyps. Most polyps are nonneoplastic and rarely cause symptoms. cholecystectomy is advocated for polyps greater than 10 mm in size because of increased risk of adenomatous or carcinomatous features.- - - - - - - - - - ranking = 1.5keywords = gallbladder (Clic here for more details about this article) |
5/15. Combined diagnostic imaging of adenomyomatosis of the gallbladder.The consistency of a request for liver MRI and MR-cholangiopancreatography in a patient with an occasional US-finding of mural thickening of gallbladder fundus > or = 3 mm in size was assessed. The differential US diagnosis in case of focal mural thickening was analyzed in combination with the other findings to justify the radiologicoclinical reliability of the request. overall, these findings suggested the diagnostic hypothesis of adenomyomatosis, then confirmed by a second level in-depth examination, namely liver MRI and MR-cholangiopancreatography.- - - - - - - - - - ranking = 1.25keywords = gallbladder (Clic here for more details about this article) |
6/15. Polypoid leiomyosarcoma of the gallbladder: study of a case associated with adenomyomatous hyperplasia.A case of polypoid leiomyosarcoma of the gallbladder arising in association with pre-existing adenomyomatous hyperplasia is described. The patient, a 34-year-old woman with symptoms of cholelithiasis, underwent a cholecystectomy for gallstones. The resected specimen showed, in addition to multiple stones, a large, rubbery, broad-based polypoid mass in the fundus. Histologic examination showed a malignant spindle cell proliferation with immunophenotypic features of smooth muscle differentiation. The base of the lesion showed features of adenomyomatous hyperplasia. The possible relationships of this lesion with adenomyomatous hyperplasia and other stromal lesions of the gallbladder are reviewed.- - - - - - - - - - ranking = 1.5keywords = gallbladder (Clic here for more details about this article) |
7/15. Combined segmental and focal adenomyomatosis involving the body of the gallbladder.Adenomyomatosis (adenomyomatous hyperplasia) of the gallbladder is a benign process of unknown origin that has been classified into three morphologic types: diffuse, segmental, and focal (fundal). Cases of combined (segmental and focal) forms involving the gallbladder body are very rare. We present the sonographic findings of a case having adenomyomatosis of the gallbladder body with focal as well as segmental forms of the disease.- - - - - - - - - - ranking = 1.75keywords = gallbladder (Clic here for more details about this article) |
8/15. Adenomyomatosis with marked subserosal fibrosis and lipomatosis of the gallbladder: mural stratification demonstrated with MR.The authors reported a case of fundal-type adenomyomatosis in which mural stratification corresponding to histopathological findings was clearly demonstrated with MR imaging. Single-shot fast spin echo images for MR cholangiopancreatography clearly visualized Rokitansky-Aschoff sinuses (RAS), which are a diagnostic clue for this disease. However, mural stratification comprising RAS with muscular proliferation, massive fibrosis and subserosal fat deposition was more precisely demonstrated in T(2)-weighted images obtained with fast spin echo.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
9/15. Adenomyomatosis of the gallbladder in childhood: report of a case and review of the literature.Adenomyomatosis of the gallbladder is considered an acquired pathologic condition that affects adults, with only 2 cases previously described in childhood. We report on a 5-year-old boy with incidental detection of this lesion by ultrasonography. Pathologic and clinical assessments are discussed in addition to treatment decision-making, including current insights into the relation between adenomyomatosis and malignancy of the gallbladder. The liberal use of ultrasonography in children with abdominal pain may result in detection of an increasing number of asymptomatic patients. caregivers should be aware of this condition and its therapeutic implications in the pediatric population.- - - - - - - - - - ranking = 1.5keywords = gallbladder (Clic here for more details about this article) |
10/15. Complete pancreatic heterotopia of gallbladder with hypertrophic duct simulating an adenomyoma.The gallbladder is an unusual location of pancreatic heterotopia, defined as the presence of pancreatic tissue lacking anatomical and vascular continuity with the main body of the gland. A 28-year-old man presented with anorexia, nausea and pain in the right upper abdomen. On physical examination, the abdomen was tender to palpation and Murphy sign was positive. The patient underwent a cholecystecomy. This case, in our opinion, is very interesting since it permits to consider a controversial issue in the pathology of the gallbladder. The histological appearance of ductal structure in pancreatic heterotopia resembles the histological picture of both Aschoff-Rokitansky (AR) sinuses and adenomyomas. This finding suggests that these lesions are linked by a common histogenetic origin. We suggest that the finding of an adenomyoma in the gallbladder should prompt an extensive sampling of the organ in order to verify the coexistence of pancreatic rests.- - - - - - - - - - ranking = 1.75keywords = gallbladder (Clic here for more details about this article) |
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