Follicular cholecystitis with cholelithiasis – A diagnostic pitfall

2021 ◽  
Vol 6 (4) ◽  
pp. 316-318
Author(s):  
Jaydeep N Pol ◽  
Neha M Bhosale ◽  
Mahendra Atmaram Patil ◽  
Vaishali J Pol
Keyword(s):  
Gall Bladder ◽  
Histopathological Examination ◽  
Bladder Wall ◽  
Chronic Cholecystitis ◽  
Bladder Tissue ◽  
Lymphoid Follicles ◽  
Diagnostic Pitfall ◽  
Germinal Centres ◽  
Gall Bladder Wall ◽  
Difficult Cases

Follicular Cholecystitis (FC) is an extremely rare subtype of Chronic Cholecystitis (CC). It is characterized by hyperplastic lymphoid follicles along with prominent germinal centers. It constitutes about 2% of routine cholecystectomies. In this article, we report a case of FC in a 69 years lady. She had abdominal pain, clinically diagnosed as Calculus cholecystitis and managed by laparoscopic cholecystectomy. Grossly, thickening of the gall bladder wall was noted. Histopathological examination revealed gall bladder wall infiltrated by dense lymphoid infiltrate forming lymphoid follicles with prominent germinal centres. Hence, we rendered a diagnosis of FC. The purpose of presenting this case is to make pathologists aware about this entity. One should not mistake this lesion for lymphoma. A careful histopathological examination is diagnostic and Immunohistochemistry may be helpful in difficult cases.Follicular Cholecystitis is extremely rare variant of Chronic cholecystitis. It is characterized by at least 3 Lymphoid Follicles per cm of Gall Bladder tissue with inflammatory infiltrate composed almost exclusively of scattered well-formed Lymphoid Follicles. Pathologist must be familiar with this entity to avoid misdiagnosis of lymphoma.

scholarly journals Partial Cholecystectomy Safe and Effective

HPB Surgery ◽  
1993 ◽  
Vol 7 (1) ◽  
pp. 61-65 ◽  
Author(s):  
Md. Ibrarullah ◽  
L. K. Kacker ◽  
S. S. Sikora ◽  
R. Saxena ◽  
V. K. Kapoor ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Bladder Wall ◽  
Common Bile Duct Stones ◽  
Chronic Cholecystitis ◽  
Bile Duct Stones ◽  
Dyspeptic Symptoms ◽  
Gall Bladder Wall ◽  
Difficult Cholecystectomy ◽  
Infective Complications

Patients undergoing surgical treatment for calculous disease were considered to have had a partial cholecystectomy performed when a part of the gall bladder wall was retained for technical reasons. Forty patients underwent partial cholecystectomy: for chronic cholecystitis (20), acute cholecystitis (4), Mirizzi's syndrome (14), portal hypertension or partially accesible gall bladder (one patient each). Four patients (10%) developed infective complications and two patients had retained common bile duct stones. In a mean follow up period of 13 months (range 1–36 mths), only 3 patients have ongoing mild dyspeptic symptoms while the rest have remained asymptomatic. Partial cholecystectomy has been found to be a safe and effective procedure in difficult cholecystectomy situations, since it combines the merits of cholecystectomy and cholecystostomy.

scholarly journals Patterns of Gall Bladder Wall Thickening in Dengue Fever: A Mirror of the Severity of Disease

2017 ◽  
Vol 03 (02) ◽  
pp. E76-E81 ◽  
Author(s):  
Jitendra Parmar ◽  
Chander Mohan ◽  
Maulik Vora
Keyword(s):  
Gall Bladder ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Warning Signs ◽  
Severe Dengue ◽  
Wall Thickening ◽  
Severity Of Disease ◽  
Gall Bladder Wall ◽  
Track Pattern ◽  
Honeycomb Pattern

Abstract Background Dengue fever is a major public health problem with an increased incidence in recent years. Gall bladder wall thickening has been reported as one of the most common findings in dengue fever. There is a paucity of literature regarding the various patterns of gall bladder wall thickening in dengue fever and their significance in predicting the severity of disease. Methodology and Significant Findings Out of 93 seropositive patients included in the study, 54 patients with dengue fever had gall bladder wall thickening. 4 patterns of gall bladder wall thickening are demonstrated in this study. A uniform echogenic pattern in 20 patients, striated or tram track pattern in 11 patients, an asymmetric pattern in 2 patients and a honeycombing pattern in 21 patients. The range of patterns of wall thickening included normal wall thickening or uniform echogenic wall thickening in DF without warning signs, a striated or tram track pattern, and a honeycomb pattern in severe DF. Serial ultrasound done on consecutive alternate days revealed a change in the pattern of gall bladder wall thickening according to the severity of disease. Conclusion The present study revealed 4 distinct patterns of gall bladder wall thickening. The uniform echogenic pattern was found to be more prevalent in dengue fever without warning signs, while the honeycomb pattern was found to be more prevalent in severe dengue fever. A change in the pattern of gall bladder wall thickening on subsequent serial ultrasound can predict the severity of the disease.

Investigation of the association between gall bladder wall thickness and hypoalbuminaemia in dogs

2021 ◽  
Author(s):  
J. Sparago ◽  
N. Rademacher ◽  
S. Dehghanpir ◽  
J. Post ◽  
C. C. Liu ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Wall Thickness ◽  
Bladder Wall ◽  
Bladder Wall Thickness ◽  
Gall Bladder Wall

scholarly journals Routine Histopathological Examination After Cholecystectomy

KYAMC Journal ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 184-187
Author(s):  
Md Abu Bakar Siddiue ◽  
Firoz Mahmud ◽  
M Fardil Hossain Faisal ◽  
Md Fazlur Rahman ◽  
Bidhan C Das ◽  
...  
Keyword(s):  
Observational Study ◽  
Gall Bladder ◽  
General Surgery ◽  
Histopathological Examination ◽  
Chronic Cholecystitis ◽  
Common Finding ◽  
Neoplastic Lesion ◽  
Medical University ◽  
Malignant Condition ◽  
Macroscopic Examination

Background: Cholecystectomy is one of the commonest surgeries in medical practice. Sometimes malignant condition cannot be assessed pre-operatively. Histopathology require for tissue diagnosis. Objective: To assess whether the histopathogical examination is really needed for all bladder specimens resected for cholelithiasis and cholecystitis. Materials and Methods: This observational study was carried out in the General Surgery Unit, Department of Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka from May, 2016 to April, 2017. A total number of 95 patients were included in this study. Results: Total of 95 gallbladder specimens were submitted for histopathological examination where 33.7% were males and 66.3 % were females with mean age of 46+12.86 years. Chronic cholecystitis was the most common finding in 91.6% of cases whereas Xanthogranulomatous 2.1%. Six of the gall bladders showed adenocarcinoma (6.3%), of which four had changes on ultrasound and macroscopic gall bladder analysis (MGAS) disturbances were found in 5 cases and 1 case was found incidentally on histopathological examination. On ultrasound, only four (66.66%) and peroperative macroscopic examination by surgeon only 5(83.3%) had a clue of carcinoma. Conclusion: It could be concluded that , routine histopathological examination of gallbladder after cholecystectomy is necessary as USG sometimes can not differentiate neoplastic lesion from inflammatory one. KYAMC Journal Vol. 10, No.-4, January 2020, Page 184-187

scholarly journals Clinicopathological correlation of 18F-FDG PET in characterizing gall bladder wall thickening

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S711-S712
Author(s):  
K. Vishnu ◽  
V. Gupta ◽  
T.D. Yadav ◽  
B.R. Mittal ◽  
N. Kalra ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Fdg Pet ◽  
Bladder Wall ◽  
Wall Thickening ◽  
Clinicopathological Correlation ◽  
Gall Bladder Wall ◽  
18F Fdg

Sonographic Evidence of Ascites, Pleura-Pericardial Effusion and Gallbladder Wall Edema for Dengue Fever

2011 ◽  
Vol 26 (5) ◽  
pp. 335-341 ◽  
Author(s):  
M. Motla ◽  
S. Manaktala ◽  
V. Gupta ◽  
M. Aggarwal ◽  
S.K. Bhoi ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pericardial Effusion ◽  
Gall Bladder ◽  
Renal Dysfunction ◽  
Dengue Fever ◽  
Bladder Wall ◽  
Gallbladder Wall ◽  
World Population ◽  
Gall Bladder Wall ◽  
The Mean

AbstractIntroduction: Radiographic findings of dengue fever have not yet been clearly elucidated in relation to clinical and serological findings, despite the fact that two-fifths of the world population lives in areas where the virus is endemic. The current study is a retrospective analyzis of ultrasonographic (USG) features of patients presenting with probable dengue fever during the outbreak of DF of 2006 in North India.Methods: Case records of a 169 patients with probable dengue fiver were included. Ten individual sonographic parameters were reviewed vis-à-vis ascites, hepatomegaly, splenomegaly, gall bladder wall edema (GBWE), pleural effusion (right or left or both), pericardial effusion, pericholecystic collection, perinephric collection. Subjects who had GB wall thickness >3 mm as measured on ultrasound were identified as positive for GBWE. The cases were analyzed in view of their serological profile.Results: The mean age of the subjects was 27.9 +/− 13.4 years. The mean value of the platelet count was 57.4 +/− 22.3 x 103/cmm. The most common ultrasonographic feature was ascites (126, 74.6%) followed by gall bladder wall edema (122, 72%), hepatomegaly (78, 46.2%), splenomegaly (66, 39.1%) and pericholecystic collection (63, 37.3%); 48 (28.4%) subjects demonstrated evidence of pleural effusion on the right side, while 19 (11.2%) had bilateral effusion. None of the subjects had an isolated left pleural effusion. Twenty-seven (16%) subjects reported bleeding manifestations in the form of petechiae and five (3%) developed renal dysfunction. Presence of pleural and pericardial effusions was found to be specific while ascites and GBWE were identified as highly sensitive markers for seropositive Primary DF.Conclusions: Ultrasonographic evidence of ascites, pleuro-pericardial effusion, and gallbladder wall edema are rapidly aquired, non-invasive markers of dengue and can be helpful before serological investigations become available. These findings may indicate severity and may herald the onset of bleeding (petechiae) or predict the development of acute renal dysfunction.

scholarly journals Is there Any Justification for the Routine Histological Examination of Straightforward Cholecystectomy Specimens?

2007 ◽  
Vol 89 (3) ◽  
pp. 238-241 ◽  
Author(s):  
B Darmas ◽  
S Mahmud ◽  
A Abbas ◽  
AL Baker
Keyword(s):  
Gall Bladder ◽  
Histological Examination ◽  
Bladder Carcinoma ◽  
Histopathological Examination ◽  
Bladder Wall ◽  
Laboratory Data ◽  
B Cell Lymphoma ◽  
Gall Bladder Carcinoma ◽  
Pathology Laboratory ◽  
Operative Notes

INTRODUCTION Gall bladder carcinoma is a rare malignancy that carries a very poor prognosis. Laparoscopic cholecystectomy (LC) is established as the gold-standard treatment for symptomatic gall stones. The aim of the study was to assess the incidence of gall bladder carcinoma and the possibility of reducing the routine histological examination of gall bladder specimens. PATIENTS AND METHODS Pathology laboratory data of gall bladder specimens over a period of 5 years (June 2000 to July 2005) were analysed retrospectively. The case notes were retrieved in all cases of malignancies. RESULTS The total number of specimens was 1452. Four (0.27%) cases of primary gall bladder carcinoma, one case of primary B-cell lymphoma and one secondary carcinoma were detected as well as one case of intra-epithelial neoplasia. Operative notes revealed that there was a high index of suspicion of malignancy in all cases. Of the 4 primary gall bladder carcinomas, 3 were stage T2 and one T4. Pre-operative ultrasound suspected carcinoma in only one case but a thickened gall bladder wall was noted in all cases. CONCLUSIONS All cases of gall bladder carcinoma were suspected pre-operatively or intra-operatively. Histological examination did not alter the management or outcome in any of the cases. We suggest that selectively sending specimens for histopathological examination would result in reduced demands on the histopathology department without compromising patient safety.

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