Primary Gallbladder Small Lymphocytic Lymphoma as a Rare Postcholecystectomy Finding

Abstract

Introduction. Primary lymphoma of the gallbladder is an extremely rare entity with approximately 50 cases reported so far. In many of these cases the presenting symptoms were mimicking symptomatic gallstone disease and the diagnosis was made postoperatively, especially when the preoperative imaging results were far from suspicious for malignant disease. Patients and Methods. We report a case of primary lymphoma of the gallbladder in an 85-year-old man with gallstone disease, who was admitted for elective cholecystectomy 2 months after an episode of acute cholecystitis and pancreatitis. Histological evaluation of the specimen revealed a small lymphocytic lymphoma of the gallbladder. This type of primary gallbladder lymphoma has not been previously reported. Discussion. The most common primary lymphomas of the gallbladder are MALT lymphomas and diffuse large B-cell lymphomas, although a variety of other histological types have been reported. The association of these lesions with chronic inflammation is the most convincing theory for their pathogenesis. For lesions confined to the gallbladder, cholecystectomy is considered to be sufficient, while supplementary chemotherapy significantly improves prognosis in more advanced disease.

Primary gallbladder lymphoma presenting with perforated cholecystitis and hyperamylasaemia

“…Primary gallbladder lymphoma (PGL) is rare with approximately 50 cases reported in the literature. 1 PGL commonly presents as cholecystitis. 2 Extranodal marginal zone lymphoma is the common subtype, and it is more common in old age and women.…”

A Rare Case of Systemic Adult Burkitt Lymphoma Presenting as Acute Acalculous Cholecystitis

“…When AAC is caused by a mass arising from the gallbladder or extrahepatic duct, the distinction between gallbladder adenocarcinoma and lymphoma is difficult to achieve without histological confirmation, as was the case with our patient. 2,5 On computed tomography, low-grade lymphomas may present as a slight thickening in the gallbladder wall, whereas high-grade lymphomas tend to form a solid mass or irregular thickening in the wall, but this patient did not have a solid mass more indicative of high-grade lymphoma. 14 Because of a low incidence rate, histopathology should only be performed in patients with suspected malignancy because it would not be cost-effective.…”

“…3,4 Patients with widespread lymphoproliferative disease with secondary infiltration of the gallbladder is unusual. 5 We present an extremely rare case of AAC due to sporadic adult Burkitt lymphoma.…”

Primary Non-Hodgkin’s Lymphoma of the Gallbladder: Α Population-based Analysis

“…We also summarized PNHL-GB cases previously described in the literature (Table IV) (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). We found that most cases of PNHL-GB are diagnosed incidentally in cholecystectomy specimens (7).…”