A Case of Tuberculosis of the Gallbladder Associated with Gallbladder Carcinoma

Yoshiaki Fujiwara, Tsuyoshi Abe, Takuro Saito, TakaoTsuchiya, Yoshihiro Satoh, Akira Kenjo and Mitsukazu Gotoh

Department of Surgery I, Fukushima Medical University School of Medicine

We report a case of tuberculosis of gallbladder associated with gallbladder carcinoma. A 73-year-old man admitted for upper abdominal pain was found on gallbladder ultrasonography to have wall thickening, debris, and a high echoic mass in the neck of the gallbladder. Endoscopic retrograde cholangiography failed to image the gallbladder due to neck occlusion, diagnosed as impacted cholecystolithiasis. We conducted cholecystectomy, and the resected specimen showed carcinoma in the gallbladder neck which confirmed by frozen pathological examination. We then combined extended cholocystectomy with 2-cm wedge resection of the gallbladder bed of the liver and regional lymphadenectomy. Microscopically, moderately differentiated tubular adenocarcinoma had invaded the subserosal layer of the gallbladder wall. We also found a thick fibrous wall surrounding a caseous center, in which acid fast bacilli were found by staining with Ziehl-Neelsen technique. A variable number of Langhans' giant cells and lymphocytes were also found compatible with tuberculosis of the gallbladder.

Key words
gallbladder carcinoma, tuberculosis

Reprint requests
Mitsukazu Gotoh Department of Surgery I, Fukushima Medical University School of Medicine 1 Hikarigaoka, Fukushima, 960-1295 JAPAN

Accepted
November 27, 2001

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