PMC5585651_01
Ultrasound of the gallbladder demonstrating an irregular lesion along the gallbladder wall measuring 2.9 x 1.0 cm.
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A sonographic exam of the right upper quadrant of the abdomen was performed for evaluation of liver cysts and incidentally noted an irregular lesion along the gallbladder wall (Figure 1).
Fused PET/CT axial image demonstrating intense increased activity in the gallbladder (black arrow).
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The PET scan showed a focus of increased metabolic activity with maximum SUV of 22.1 within the gallbladder in the region of abnormality visualized on the ultrasound and MRI (Figures 2 and 3).
Whole body MIP image showing abnormal focal activity in the region of the gallbladder (red arrow).
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The PET scan showed a focus of increased metabolic activity with maximum SUV of 22.1 within the gallbladder in the region of abnormality visualized on the ultrasound and MRI (Figures 2 and 3).
(a) Gallbladder mucosa with dark brown pigmented polypoid lesion measuring 2.7 x 1.5 x 1.3 cm. (b) Sheets of malignant epithelioid cells are seen with eosinophilic cytoplasm and prominent nucleoli. Gallbladder epithelium can be seen (arrow). (c) Higher power showing malignant cells with hyperchromatic large atypical nuclei with eosinophilic cytoplasm and scattered brown pigment. (d) Immunohistochemistry for melanocytic marker HMB-45 showing diffuse and strong staining.
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The patient underwent cholecystectomy with final pathology remarkable for metastatic melanoma (Figure 4).