J Korean Soc Radiol.  2010 Nov;63(5):453-457. 10.3348/jksr.2010.63.5.453.

Adenocarcinoma Arising in Segmental Adenomyomatosis of the Gallbladder: A Case Report

• Yeon JS
• Cho JS
• Shin KS
• Lee BS
• Lee HY
• Song IS
• Kang DY

• KMID: 2097917
• DOI: http://doi.org/10.3348/jksr.2010.63.5.453

Abstract

We report here a rare case of adenocarcinoma arising from segmental adenomyomatosis of the gallbladder itself. CT images showed segmental annular wall thickening of the gallbladder body with regional lymph node enlargement, which could not exclude adenomyomatosis associated with malignancy. Therefore, we performed MRI and PET/CT for further evaluation. T2 weighted MRI revealed multiple tiny intramural cystic lesions in the focal wall thickening of the gallbladder, suggesting adenomyomatosis. However, PET/CT showed increased activity in the lesion of the gallbladder and regional lymph node, suggesting malignancy, which was pathologically confirmed as adenocarcinoma arising from adenomyomatosis.

MeSH Terms

Adenocarcinoma
Gallbladder
Gallbladder Diseases
Gallbladder Neoplasms
Lymph Nodes

Figure

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  Fig. 1 Adenocarcinoma arising from segmental adenomyomatosis of the gallbladder in a 67-year-old man. A. Transverse contrast-enhanced MDCT image showing focal annular wall thickening (arrow) of the gallbladder. B. Transverse contranst-enhanced MDCT image showing an enlarged common hepatic lymph node (arrowhead), suggesting metastasis. C. Transverse T2-weighted MR image showing multiple tiny intramural hyperintense cystic lesions (thin arrows), which are not identified on the CT image. D. Transverse fused PET/CT image showing increased FDG activity in the annular wall thickening of the gallbladder (arrow) and common hepatic lymph nodes (arrowhead), which are consistent with gallbladder cancer and lymph node metastasis. E. Photograph of the cut surface of the gross specimen shows a yellowish-white colored wall thickening with multiple tiny intramural cysts. F. Photomicrograph showing normal epithelium of the Rokitansky-Aschoff sinus (thin arrows) and enlarged stratification of the nuclei and a high frequency of mitoses (arrows) representing adenocarcinoma (H & E, original magnification ×100). G. Photomicrograph of immunohistochemical stain with p53 showing positive staining (arrows) in adenocarcinoma (p53, original magnification ×100).

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