Characteristics of contrast-enhanced ultrasound in carcinogenesis of gallbladder papillary adenoma: A case report

Gallbladder cancer is a malignant tumor with high mortality. Early diagnosis is significance to improve the prognosis of patients. Gallbladder adenoma is recognized as a kind of precancerous disease, for the past few years, contrast-enhanced ultrasound was used in the diagnosis of biliary tumors. This case is about gallbladder papillary adenoma with carcinogenesis. There is rare literature on the contrast-enhanced ultrasound manifestations of this type of disease. We hope that this report can help improve the recognition of contrast-enhanced ultrasound features and improve the accuracy of early diagnosis of gallbladder cancer.

Gallbladder adenoma in a domestic shorthair cat

Case summary A 13-year-old neutered female domestic shorthair rescue cat presented asymptomatically with raised hepatic enzymes following a routine pre-anaesthetic blood test. Cholangitis was suspected, and supportive treatment with 2 weeks of amoxicillin–clavulanic acid and 4 weeks of ursodeoxycholic acid and S-adenosylmethionine was trialled, with no improvement in biochemistry parameters. Clinicopathological investigations also revealed a markedly raised total bilirubin and abnormal bile acid stimulation test. Abdominal ultrasonography revealed pathological changes in the gallbladder, hepatomegaly with increased echogenicity and markedly thickened common bile duct walls. An exploratory laparotomy was performed revealing a grossly abnormal gallbladder with a small rupture at the dorsal fundus, which was managed via cholecystectomy. Pancreatic and hepatic biopsies were collected concurrently. Histopathology from the submitted samples revealed a gallbladder adenoma, chronic neutrophilic cholangitis and nodular hyperplasia of the pancreas. Culture of the gallbladder bile was negative but may be attributable to the initial treatment with antibiosis. At the time of writing, 5 months postoperatively, the cat had recovered well and remained asymptomatic and clinically healthy, but hepatic enzymes and bilirubin were only mildly reduced from the preoperative levels, despite the cat remaining clinically normal. Relevance and novel information To our knowledge, this is the first case of a gallbladder adenoma confirmed histopathologically in a feline patient. Our findings suggest that although gallbladder neoplasia is rare in cats, this benign tumour should be considered a differential diagnosis.

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.