Adénome de la vésicule biliaire avec aspect cholestérolose

Abstract

Gallbladder adenoma is a benign, often asymptomatic tumor, discovered in 0.5% of cholecystectomy specimens. We report the case of a 79-year old woman, admitted with suspected acute pancreatitis of biliary origin. She received cholecystectomy. Gross examination showed a yellowish vegetative and friable lesion at the level of the gallbladder fundus, measuring 1,7 cm on the major axis. Histological examination showed tumor proliferation with papillary and tubular architecture, bordered by pseudostratified biliary-type epithelium Lamina propria was the seat of many clusters of foamy histiocytes. The diagnosis was tubular papillary biliary-type adenoma with low-grade dysplasia associated with cholesterolosis lesions. Adenomas of the gallbladder usually affect adult women. Clinically, they are often asymptomatic. They appear as sessile or pedunculated polypoid structures and projecting into the lumen of the gallbladder. Ultrasound or endoscopic ultrasonography can highlight these lesions and sometimes specify their nature in 5% of cases. Cholesterol polyps are always benign, accounting for nearly half of the cases, and are usually infracentimetric. In our case, the histological diagnosis was obvious but the presence of foamy histiocytes in the lamina propria was unusual. The entire lesion should be well studied histologically to detect high-grade dysplasia lesions or signs of invasion.

Pan African Medical Journal 2016; 24