PMC3015889_01
Right upper quadrant US demonstrating the hyperechoic lesion in the region of the gallbladder fundus.
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F1
During a workup for abnormal liver function tests, a rounded hyperechoic mass appeared to be within the fundus of the gallbladder, with a year's interval increase from 1.5x1.4 cm to 1.8x1.7 cm (Figure 1).
Laparoscopic view of the CHFC in situ in the gallbladder fossa, prior to dissection.
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F2
Upon lateral and cephalad retraction of the gallbladder, a well-encapsulated mass was identified in the gallbladder fossa (Figure 2).
Laparoscopic view of CHFC between the gallbladder fossa and hepatic parenchyma, following ligation and transection of the cystic duct and artery.
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F3
The mass was then circumferentially dissected from the liver bed, taking a thin margin of subcapsular tissue en-bloc with the specimen (Figure 3).
Photomicrograph of the ciliated hepatic foregut cyst wall, demonstrating the characteristic pseudostratified ciliated epithelium, subepithelial connective tissue, smooth muscle layer, and outer fibrous capsule with hematoxylin-eosin staining, 200X magnification.
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F4
Histological analysis demonstrated an inner layer of ciliated stratified columnar epithelium with scattered goblet cells surrounded by loose connective tissue, a discontinuous smooth muscle layer, and an outer fibrous capsule (Figure 4).