PMC4066574_01
Computed axial tomography (CAT) demonstrating thickening of the gallbladder with surrounding edema and inflammation.
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Dilation of intrahepatic ducts and common bile duct were not seen (Fig. 1).
(a) Hematoxylin-Eosin stained section from gallbladder wall showing diffuse infiltrates of mononuclear cells with irregular nuclei and some with prominent nucleoli. Scattered lymphocytes, plasma cells and macrophages are also present. (b) The majority of cells stain positive for CD68 KP-1 epitope, which is positive not only in macrophages but also in myeloid and monocytic precursors. (c) Only rare cells stained positive for CD68-R PGM-1 epitope, which is more macrophage specific.
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Histopathologic examination of the specimen demonstrated multiple scattered, highly atypical single cells admixed with some plasma cells, small lymphocytes and macrophages consistent with leukemic infiltration (Fig. 2a). The abnormal cells demonstrated immunohistochemical staining for CD68 (KP1), CD33 and CD117, however, CD34 was not increased (Fig. 2b and c).