Abstract
We report herein two cases of carcinoma in situ of the gallbladder associated with cholesterosis. The patient in case 1 was an 81-year-old man who underwent a cholecystectomy for cholelithiasis. The resected specimens revealed gallbladder cancer in the fundus which was diagnosed histologically as mucinous carcinoma. Other findings included 13-mm, 12-mm, and 5-mm poly-poid lesions in the neck of the gallbladder which macroscopically appeared to be cholesterol polyps, but histologically demonstrated carcinoma in situ with cholesterosis. The patient in case 2 was a 76-year-old man in whom ultrasonography revealed a highly echogenic, elevated lesion in the gallbladder. Cholecystectomy was performed, and a 33×28-mm papillary, elevated lesion with cholesterosis was resected from the neck of the gallbladder. Histologically, this was demonstrated to be papillary adenocarcinoma in situ with cholesterosis surrounded by glandular dysplasia. The distribution of the carcinomas and cholesterosis in both of these patients suggests that the adenoma or carcinoma of the gallbladder had occurred first. Then, the tumor epithelium absorbed cholesterol from the bile, and foamy cells were produced. Thus, when treating cholesterol polyps, it should be remembered that it is often difficult to distinguish between cholesterol polyp and gallbladder cancer with cholesterosis.
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Iseki J, Ushiyama K, Beppu T, et al. Early carcinoma of the gallbladder—a clinical and pathological study (in Japanese with English abstract). Nippon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 1982;79:2112–2120.
Iseki J, Ushiyama K, Beppu T, et al. Polyp of the gallbladder: a clinical and pathological study (in Japanese with English abstract). Nihon Geka Gakkai Zasshi (J Jpn Surg Society) 1982;83:1429–1436.
Christensen AH, Ishak KG. Benign tumors and pseudotumors of the gallbladder. Report of 180 cases. Arch Path 1970;90:423–432.
Asada Y, Miura S, Mitsui T, et al. Papillary tumor of the gallbladder demonstrated by endoscopic ultrasonography: a case report (in Japanese with English abstract). Fukubu Gazo Shinndan (Abdom Imaging Diagn) 1990;10:94–98.
Edmondson HA. Tumors of gallbladder and extrahepatic bile ducts. Armed Forces Institute of Pathology, Washington, D.C., 1967; fascicle 26, p 21.
Koga A Toudou S, Nishimura M. Electron microscopic observations on cholesterosis of the gallbladder, with special reference to its pathogenesis (in Japanese with English abstract). Nihon Shokakibyo Gakkai Zasshi (Jpn J Gastroenterol) 1974;71:1085–1101.
Hatae Y, Kikuchi M, Sugawa M, et al. Diffuse papillomatous cholesterosis in gallbladder with metaplastic epithelium: a case report (in Japanese with English abstract). I To Chou (Stomach and Intestine) 1978;13:695–700.
Feldman M, Feldman M Jr. Cholesterosis of the gallbladder. An autopsy study of 165 cases. Gastroenterology 1954;27:641–648.
Yamagiwa H. Dysplasia of gallbladder: Its pathological significance. Acta Pathol Jpn 1987;37:747–754.
Yamagiwa H, Tomiyama H. Intestinal metaplasia-dysplasia-carcinoma sequence of the gallbladder. Acta Pathol Jpn 1986;36:989–997.
Yamamoto M. Histogenesis of well-differentiated adenocarcinoma of the gallbladder. Path Res Pract 1989;184:279–286.
Mizumoto R. Protruded lesions of the gallbladder (in Japanese). Kan Tan Sui (Liver Bil Tract and Pancreas) 1991;22:697–698.
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Akiyama, T., Sahara, H., Seto, K. et al. Gallbladder cancer associated with cholesterosis. J Gastroenterol 31, 470–474 (1996). https://doi.org/10.1007/BF02355043
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DOI: https://doi.org/10.1007/BF02355043