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Fundal variant adenomyomatosis of the gallbladder: report of three cases and review of the literature.

Ozgonul A, Bitiren M, Guldur ME, Sogut O, Yilmaz LE - J Clin Med Res (2010)

Bottom Line: They may involve in the fundal localization as a second frequency and have a predilection for the middle and elderly-aged women.The chronic irritation is mostly aetiological factor and rarely has malignant potential.In this paper, the authors present the clinicopathological features of three cases with adenomyomatosis of the gallbladder and discuss under the light of current literature because of the rarity of these conditions.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Harran University, School of Medicine, Sanliurfa, Turkey.

ABSTRACT

Unlabelled: Adenomyomatosis of the gallbladder (adenomyomas or adenomyomatous hyperplasia) is relatively uncommon tumor or tumor-like lesions that are found in 2%5% of all cholecystectomies. They may involve in the fundal localization as a second frequency and have a predilection for the middle and elderly-aged women. Adenomyomas are histologically characterized by epithelial proliferation and muscular hyperplasia of the gallbladder. The chronic irritation is mostly aetiological factor and rarely has malignant potential. In this paper, the authors present the clinicopathological features of three cases with adenomyomatosis of the gallbladder and discuss under the light of current literature because of the rarity of these conditions.

Keywords: Gallbladder; Adenomyomatosis; Fundal variant.

No MeSH data available.


Related in: MedlinePlus

Photomicrographs of gallbladder sections: (a) Proliferation of the mucosal glandular structures inceptiving from the mucosa of gallbladder; (b) Hyperplasia of the smooth muscle cells among them (H&E stains; original magnifications, x40); (c) Aggregation of cystically dilated glandular structures surrounded by a hiperplasic smooth muscle tissu evaluate columnar without nuclear atypia in glandular epithelium. The glandular structures are lined by an unistratified epithelium at high magnification (H&E stain; original magnification, x100); (d) Immunohistochemical stains show the glandular columnar cells to be positive for cytokeratin-7 expression (original magnification, x200); (e) Immunohistochemical stains show the muscularis layer to be positive for alpha-smooth muscle actin expression ( original magnification, x100).
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Figure 2: Photomicrographs of gallbladder sections: (a) Proliferation of the mucosal glandular structures inceptiving from the mucosa of gallbladder; (b) Hyperplasia of the smooth muscle cells among them (H&E stains; original magnifications, x40); (c) Aggregation of cystically dilated glandular structures surrounded by a hiperplasic smooth muscle tissu evaluate columnar without nuclear atypia in glandular epithelium. The glandular structures are lined by an unistratified epithelium at high magnification (H&E stain; original magnification, x100); (d) Immunohistochemical stains show the glandular columnar cells to be positive for cytokeratin-7 expression (original magnification, x200); (e) Immunohistochemical stains show the muscularis layer to be positive for alpha-smooth muscle actin expression ( original magnification, x100).

Mentions: On microscopic examination, within a background of connective tissue, bundle-arranged smooth muscle cells, and numerous glandular lobules floored with columnar epithelial cells with nuclei located at the base were examined. Some of these glandular structures were cystically dilated and irregularly shaped, and no mitotic figures, atypical or pleomorphic changes were demonstrated (Fig. 2a, Fig. 2b, and Fig. 2c). Immunohistochemical stains performed on sections prepared from paraffin-embedded blocks using an avidin-biotin peroxidase complex method. The glandular epithelium revealed positive immunohistochemical reaction for cytokeratin-7 (CK; clone OV-TL12/30, dilution 1:50, DAKO), cytokeratin-20 (CK; clone Ks20.8, dilution 1:50, DAKO), (Fig. 2d). In addition, hyperplasic smooth muscle cell clusters stained diffusely positive for alpha-smooth muscle actin (Clone 1A4, dilution 1:40, DAKO) (Fig. 2e). These histopathological and immunohistochemical findings mentioned above were confirmed adenomyomatosis of the gallbladder in all cases.


Fundal variant adenomyomatosis of the gallbladder: report of three cases and review of the literature.

Ozgonul A, Bitiren M, Guldur ME, Sogut O, Yilmaz LE - J Clin Med Res (2010)

Photomicrographs of gallbladder sections: (a) Proliferation of the mucosal glandular structures inceptiving from the mucosa of gallbladder; (b) Hyperplasia of the smooth muscle cells among them (H&E stains; original magnifications, x40); (c) Aggregation of cystically dilated glandular structures surrounded by a hiperplasic smooth muscle tissu evaluate columnar without nuclear atypia in glandular epithelium. The glandular structures are lined by an unistratified epithelium at high magnification (H&E stain; original magnification, x100); (d) Immunohistochemical stains show the glandular columnar cells to be positive for cytokeratin-7 expression (original magnification, x200); (e) Immunohistochemical stains show the muscularis layer to be positive for alpha-smooth muscle actin expression ( original magnification, x100).
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104642&req=5

Figure 2: Photomicrographs of gallbladder sections: (a) Proliferation of the mucosal glandular structures inceptiving from the mucosa of gallbladder; (b) Hyperplasia of the smooth muscle cells among them (H&E stains; original magnifications, x40); (c) Aggregation of cystically dilated glandular structures surrounded by a hiperplasic smooth muscle tissu evaluate columnar without nuclear atypia in glandular epithelium. The glandular structures are lined by an unistratified epithelium at high magnification (H&E stain; original magnification, x100); (d) Immunohistochemical stains show the glandular columnar cells to be positive for cytokeratin-7 expression (original magnification, x200); (e) Immunohistochemical stains show the muscularis layer to be positive for alpha-smooth muscle actin expression ( original magnification, x100).
Mentions: On microscopic examination, within a background of connective tissue, bundle-arranged smooth muscle cells, and numerous glandular lobules floored with columnar epithelial cells with nuclei located at the base were examined. Some of these glandular structures were cystically dilated and irregularly shaped, and no mitotic figures, atypical or pleomorphic changes were demonstrated (Fig. 2a, Fig. 2b, and Fig. 2c). Immunohistochemical stains performed on sections prepared from paraffin-embedded blocks using an avidin-biotin peroxidase complex method. The glandular epithelium revealed positive immunohistochemical reaction for cytokeratin-7 (CK; clone OV-TL12/30, dilution 1:50, DAKO), cytokeratin-20 (CK; clone Ks20.8, dilution 1:50, DAKO), (Fig. 2d). In addition, hyperplasic smooth muscle cell clusters stained diffusely positive for alpha-smooth muscle actin (Clone 1A4, dilution 1:40, DAKO) (Fig. 2e). These histopathological and immunohistochemical findings mentioned above were confirmed adenomyomatosis of the gallbladder in all cases.

Bottom Line: They may involve in the fundal localization as a second frequency and have a predilection for the middle and elderly-aged women.The chronic irritation is mostly aetiological factor and rarely has malignant potential.In this paper, the authors present the clinicopathological features of three cases with adenomyomatosis of the gallbladder and discuss under the light of current literature because of the rarity of these conditions.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Harran University, School of Medicine, Sanliurfa, Turkey.

ABSTRACT

Unlabelled: Adenomyomatosis of the gallbladder (adenomyomas or adenomyomatous hyperplasia) is relatively uncommon tumor or tumor-like lesions that are found in 2%5% of all cholecystectomies. They may involve in the fundal localization as a second frequency and have a predilection for the middle and elderly-aged women. Adenomyomas are histologically characterized by epithelial proliferation and muscular hyperplasia of the gallbladder. The chronic irritation is mostly aetiological factor and rarely has malignant potential. In this paper, the authors present the clinicopathological features of three cases with adenomyomatosis of the gallbladder and discuss under the light of current literature because of the rarity of these conditions.

Keywords: Gallbladder; Adenomyomatosis; Fundal variant.

No MeSH data available.


Related in: MedlinePlus