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Gall Bladder Pathology Online ;
Adenomyomatous Hyperplasia of Gall Bladder.
Adenomas of the
biliary tract are uncommon but may occur in multicentric papillomatosis which is rare and involves the gall
bladder and the extrahepatic biliary tree.
Gallbladder
adenomas are found in 0.5% of cholecystectomy specimens.
Familial
adenomatous polyposis and Peutz-Jeghers syndrome are associated
with an increased prevalence of adenomas of the gallbladder
and biliary tract.
Gallbladder adenomas occur
primarily in women.
Clinically,
adenomas are usually asymptomatic and discovered
incidentally during a radiologic evaluation for abdominal
pain.
The patient
may complain of chronic or intermittent right upper quadrant
pain. It may occur in patients with large adenomas or with
adenomas that obstruct the cystic duct.
Gross:
Image
Link
Gallbladder
adenomas appear as polypoid structures that project into
the gallbladder lumen and that may be sessile or
pedunculated. They are generally less than 2 cm
in size. Approximately 10% of adenomas are multiple. The majority of
cases are associated with cholelithiasis. Tubular adenomas
are typically lobular in contour, whereas papillary
adenomas have a cauliflowerlike appearance.
Microscopic
features:
Image Link1;
Image Link2
;
Image Link3 .
Gallbladder
adenomas can be classified histologically as tubular,
papillary, or tubulopapillary.
The tubular
adenoma is the most common variant. It is covered by
biliary epithelium and is composed of pyloric- or
intestinal-type glands. In the former, cuboidal or columnar
cells containing vesicular or hyperchromatic nuclei line
the pyloric-type glands. In the latter, pseudostratified
columnar epithelium lines the tubular intestinal-type glands.
Papillary
adenomas are composed of papillary structures lined by
cuboidal or columnar cells .
The term
tubulopapillary is used when both tubular glands and
papillary structures each contribute to more than 20% of
the tumour
A small
proportion of gallbladder adenomas progress to carcinoma.
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