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Gallbladder Pathology Online

Pathology of Adenoma of the Gallbladder

Dr Sampurna Roy  MD 


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.


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 cauliflower-like appearance.

Microscopic features: 

Gallbladder adenomas can be classified histologically as tubular, papillary, or tubulopapillary.

The tubular 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 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.


Further reading:

Differential diagnosis between gallbladder adenomas and cholesterol polyps on contrast-enhanced harmonic endoscopic ultrasonography.

Adenomas of the gallbladder. Morphologic features, expression of gastric and intestinal mucins, and incidence of high-grade dysplasia/carcinoma in situ and invasive carcinoma.

Mutations in the RAS/RAF/MAP kinase pathway commonly occur in gallbladder adenomas but are uncommon in gallbladder adenocarcinomas.

Large villous adenoma of gallbladder: A case report.

Non-neoplastic polypoid lesions and adenomas of the gallbladder 

Intracholecystic papillary-tubular neoplasms (ICPN) of the gallbladder (neoplastic polyps, adenomas, and papillary neoplasms that are ≥1.0 cm): clinicopathologic and immunohistochemical analysis of 123 cases.

Histological classification of epithelial polypoid lesions of the gallbladder.

Genetic alterations in gallbladder adenoma, dysplasia and carcinoma

Unicryptal gallbladder adenomas in a patient with Gardner's syndrome

Adenoma of the ampulla of Vater: a case report.

Gallbladder tubulovillous adenoma in a patient with liver fluke infection.

Do histopathologic findings improve by increasing the sample size in cholecystectomies?

Gallbladder polyps: factors affecting surgical decision.

Villous adenoma of gallbladder in a patient with systemic lupus erythematosus.

Prevalence of adenoma of gallbladder, ultrasonographic and histological assessment in a retrospective series of 450 cholecystectomy.

Differences between images of large adenoma and protruding type of gallbladder carcinoma.




Dr  Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)










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