Journal of Pathology and Translational Medicine

Case Study

Bile Granuloma Mimicking Peritoneal Seeding: A Case Report: Hasong Jeong, Hye Won Lee, Hye Ra Jung, Ilseon Hwang, Sun Young Kwon, Yu Na Kang, Sang Pyo Kim, Misun Choe; J Pathol Transl Med. 2018;52(5):339-343. Published online July 16, 2018; DOI: https://doi.org/10.4132/jptm.2018.06.02

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Laparoscopic cholecystectomy is a widely used treatment method for most cholelithiasis and is a relatively safe procedure. Foreign body granulomatous reaction to bile or gallstone spillage during laparoscopic cholecystectomy has rarely been reported. We report a case of bile granuloma after laparoscopic cholecystectomy, which mimicked peritoneal seeding. A 59-year-old Korean man presented with right upper quadrant pain. He underwent laparoscopic cholecystectomy for acute cholecystitis with cholelithiasis. Pathologic examination revealed an incidental adenocarcinoma invading the lamina propria with acute cholecystitis and cholelithiasis. After 3 months, follow-up abdominal computed tomography revealed a subhepatic nodule, which showed hypermetabolism on positron emission tomography–computed tomography. Suspecting localized peritoneal seeding, wedge resection of the liver, wedge resection of the transverse colon, and omentectomy were performed. Pathologic examination of the resected specimens revealed multiple bile granulomas. Awareness of bile granuloma mimicking malignancy is noteworthy for patient management to reduce unnecessary procedure during postoperative surveillance.

Citations

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Practices and Attitudes of Surgeons With Regard to Spilled Gallstones During Laparoscopic Cholecystectomy: A Cross-Sectional Study From Saudi Arabia
Mohammed Alfehaid, Moath Aljohani, Sajad A Salati , Shoug Alaodah, Wejdan Alresheedi, Raghad Almarshud
Cureus.2024;[Epub] CrossRef
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Polish Journal of Surgery.2022; 94(4): 1. CrossRef
Foreign body granulomas mimic peritoneal dissemination caused by incarcerated femoral hernia perforation: A case report
Shinpei Ogino, Tatsuya Matsumoto, Yosuke Kamada, Noriaki Koizumi, Hiroshi Fujiki, Kenji Nakamura, Takeshi Yamano, Chouhei Sakakura
World Journal of Clinical Oncology.2021; 12(11): 1083. CrossRef

Original Article

A Different Perspective on Macroscopic Sampling of Cholecystectomy Specimens: Asuman Argon, Ayşe Yağcı, Funda Taşlı, Tulu Kebat, Senem Deniz, Nazif Erkan, Gül Kitapçıoğlu, Enver Vardar; Korean J Pathol. 2013;47(6):519-525. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.519

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Abstract PDF

Background

Because there may be interdepartmental differences in macroscopic sampling of cholecystectomy specimens, we aimed to investigate differences between the longitudinal sampling technique and our classical sampling technique in cholecystectomy specimens in which there was no obvious malignancy.

Methods

Six hundred eight cholecystectomy specimens that were collected between 2011 and 2012 were included in this study. The first group included 273 specimens for which one sample was taken from each of the fundus, body, and neck regions (our classical technique). The second group included 335 specimens for which samples taken from the neck region and lengthwise from the fundus toward the neck were placed together in one cassette (longitudinal sampling). The Pearson chi-square, Fisher exact, and ANOVA tests were used and differences were considered significant at p<.05.

Results

In the statistical analysis, although gallbladders in the first group were bigger, the average length of the samples taken in the second group was greater. Inflammatory cells, pyloric metaplasia, intestinal metaplasia, low grade dysplasia, and invasive carcinoma were seen more often in the second group.

Conclusions

In our study, the use of a longitudinal sampling technique enabled us to examine a longer mucosa and to detect more mucosal lesions than did our classical technique. Thus, longitudinal sampling can be an effective technique in detecting preinvasive lesions.

Citations

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Claudio F. Feo, Giorgio C. Ginesu, Alessandro Fancellu, Teresa Perra, Chiara Ninniri, Giulia Deiana, Antonio M. Scanu, Alberto Porcu
International Journal of Surgery.2022; 98: 106234. CrossRef
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Lindsay Cefalu, Robert McMurray, Grant Sizemore, Gerald Bieniek, Michael Lustik, Christopher Yheulon
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2019; 29(1): 26. CrossRef
Optimal block sampling of routine, non‐tumorous gallbladders
Newton A C S Wong
Histopathology.2017; 71(1): 162. CrossRef
The Relationship Between Intracholecystic Papillary-Tubular Neoplasms and Invasive Carcinoma of the Gallbladder
Asuman Argon, Funda Yılmaz Barbet, Deniz Nart
International Journal of Surgical Pathology.2016; 24(6): 504. CrossRef

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