PMC10348478_01
Radiographic and macroscopic images of the tumor. (A) Computed tomography images of the patient (red arrows refer to the space-occupying lesion). (B) The resected gallbladder was approximately 5.0 cm in diameter. (C) The irregular mass in the gallbladder was approximately 4.5 cm x 3.0 cm x 3.0 cm in size.
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A whole abdominal enhanced computer tomography (CT) scan showed a space-occupying lesion in the gallbladder, with enlargement of multiple peripheral and retroperitoneal lymph nodes, suspected a malignant lesion ( Figure 1A ). On July 5, 2022, the patient underwent radical resection of the gallbladder, which was approximately 5.0 cm in diameter ( Figure 1B ). The space-occupying lesion was approximately 4.5 cm x 3.0 cm x 3.0 cm in size ( Figure 1C ).
Histopathology of the undifferentiated carcinoma of the gallbladder. (A) The tumor cells presented obvious atypia, diffuse patchy infiltration, growth, and poor cell adhesion (H&E staining, 100x and 200x). (B) Immunohistochemical staining showed that the neoplastic cells were positive for cytokeratin and SMARCB1 (INI1) but negative for vimentin (100x) and SMARCA4 (BRG1) (100x, 200x, and 400x).
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Postoperative pathology revealed that the tumor cells presented obvious atypia, diffuse patchy infiltration, growth, poor cell adhesion, chromatin vacuolated, nucleoli obvious, mitotic figures were easy to see, necrosis and more lymphocyte infiltration were seen ( Figure 2A ). Immunohistochemistry (IHC) showed that the tumor cells were positive for cytokeratin, synaptophysin, SMARCB1 (INI1), and negative for SMARCA4 (BRG1), CK7, CK19, p63, p40, vimentin ( Figure 2B ).