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54 year old man with thickened gallbladder wall

stevenshen 离线

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楼主 发表于 2008-12-13 07:22|举报|关注(0)
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姓    名: ××× 性别:  Male 年龄:  54
标本名称: Gallbladder 
简要病史:  
肉眼检查:

Diffusely thickened gallbladder wall

(1.5 cm) 

Frozen section diagnosis?

Differential diagnoses??

  • 54 year old man with thickened gallbladder wall图1
    图1
  • 54 year old man with thickened gallbladder wall图2
    图2
  • 54 year old man with thickened gallbladder wall图3
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×参考诊断
Granulomatous cholecystitis

stevenshen 离线

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1 楼    发表于2008-12-20 08:44:00举报|引用
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  • It is granulomatous cholecystitis...excellent diagnosis.  

  • I have seen a few such cases, on frozen section, it can be pretty tricky.

  • You might worry about lymphoma, sarcomatoid carcinoma, inflammatory pseudotumor or even sarcoma.
  • The key is to recognize 
    1. polymorphous population of inflammatory cells 
    2. recognize hitiocytes (granulomatous inflammation)
    3. lack of significant pleomorphism or mitoses 

    I hope Dr.月新 or csgcsg to comment on your experience.

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