a.k.a. cholegranulomas or cholecystic granulomas Etiology/Pathogenesis • Usually preceded by rupture of Rokitansky-Aschoff sinus Bile and lipid extruded into gallbladder wall, producing granulomatous reaction Clinical Issues • 4-9% of cholecystectomy specimens Majority…
Prevalence of 12% in autopsy studies and from 9-26% in surgical pathology studies • Usually asymptomatic and discovered incidentally at cholecystectomy Clinical significance, if any, is unclear • Peak in 5th and…
Mutations of ABCC8 or KCNJ11 genes encoding subunits of ATP-sensitive potassium channel in majority of cases Mutations of GCK, GLUD1, HSD17B10 (SCHAD), SLC16A1, HNF1A, HNF4A, or UCP2 genes in minority…
Most clinically significant infections are seen in setting of immunosuppression Etiology/Pathogenesis • Infection can be acquired before birth, at birth, or later in life Following active infection, latent infection may persist…
Enlarged, activated, or blastic T lymphocytes, eosinophils, and other inflammatory cells • Bile duct damage Lymphocytic infiltration and epithelial cell injury affecting interlobular ducts • Endotheliitis Subendothelial venous inflammation with lifting and…
Metaplasia → dysplasia → carcinoma sequence • Progression from preexisting adenocarcinoma Considered “metaplastic carcinoma” like that in breast • Gallstones present in 40-68% of cases Clinical Issues • 1-12% of all gallbladder carcinomas…
PLD occurring in 30-90% of patients Age-dependent increase in number and size of liver cysts Higher prevalence of PLD in women • Isolated PLD affecting < 0.01% of population • Asymptomatic in…
Gross AppearanceThe cut surface shows numerous variably sized cystic spaces admixed with solid areas. Minimal uninvolved liver tissue is present at the resection margin . Loose Myxoid StromaLow-power view shows…
Incidence ranges from < 1% to 7.3% in autopsy studies Clinical Issues • Majority discovered incidentally Clinically silent – Tumors under 4 cm rarely symptomatic When symptomatic, present with abdominal pain, hepatomegaly,…
