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.
adenomas are found in 0.5% of cholecystectomy specimens.
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.
adenomas are usually asymptomatic and discovered
incidentally during a radiologic evaluation for abdominal
may complain of chronic or intermittent right upper quadrant
It may occur in patients with large adenomas or with
adenomas that obstruct the cystic duct.
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
Approximately 10% of adenomas are multiple.
The majority of
cases are associated with cholelithiasis.
are typically lobular in contour, whereas papillary
adenomas have a cauliflower-like appearance.
adenomas can be classified histologically as tubular,
papillary, or tubulopapillary.
adenoma is the most common variant.
Adenomas can also be
classified by their cytoarchitectural resemblance to the different
parts of the gastrointestinal tract as pyloric gland adenoma,
intestinal-type adenoma, and biliary-type adenoma.
The lesion is covered by biliary epithelium and is composed of pyloric or
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.
adenomas are composed of papillary structures lined by
cuboidal or columnar cells.
tubulopapillary is used when both tubular glands and
papillary structures each contribute to more than 20% of
proportion of gallbladder adenomas progress to carcinoma.