PMC7968027_01
Ultrasonographic image of (a,b) the gallbladder with thickened irregular walls and intraluminal projections; and (c,d) the common bile duct with thickened walls and a variably dilated lumen
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Ultrasonographically, the gallbladder had a very unusual appearance (Figure 1). The common bile duct walls were thickened, with the lumen variably dilated throughout the duct's length to a maximum of 3 mm internal and 5 mm external diameter (Figure 1).
Histopathological low-power image of the gallbladder mass in cross section. Scale bar = 2 mm
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Histology of the gallbladder revealed that the mucosa was diffusely thickened, and formed papillary intraluminal proliferations (Figure 2).
Histopathological image of the gallbladder mass. Use of haematoxylin and eosin staining of the resected gallbladder mass revealed uniform epithelial cells, lining projections and tubules, with low numbers of inflammatory cells within the stroma. Scale bar = 50 mum
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The epithelial cells were well-differentiated cuboidal-to-columnar cells lining central fibrous stalks (Figure 3).
Macroscopic appearance of the gallbladder adenoma measuring approximately 1.3 cm x 1.2 cm
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These features were consistent with benign papillary adenoma of the gallbladder mucosa (Figure 4).
Histopathological image of the liver biopsy. This low-power (x 20) view shows the expansion of some portal areas by mixed inflammatory cell infiltrates, increased amounts of collagen (blue arrows), which is sometimes mucinous (asterisk), and biliary hyperplasia (black arrows). Haematoxylin and eosin stain; x 20
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In addition, biopsy of the medial right liver lobe showed evidence of portal areas expanded by oedematous and variably mucinous collagen, bridging adjacent portal tracts and associated with inflammation and biliary hyperplasia (Figure 5).