Abstract
A 74-year-old male patient was admitted for evaluation of exacerbated gallbladder wall thickening and Rokitansky-Ashoff sinus dilatation with elevation of tumor markers. He had past histories of adenomyomatosis with gallstones, chronic pancreatitis with pancreatic calculi, and diabetes mellitus. Occurrence of gallbladder carcinoma was highly suspected. Computed tomography during the right hepatic arterial angiography revealed the continuous internal thin layer called a mucosal line with the enhanced thickened gallbladder wall. We considered the gallbladder wall thickening was caused by chronic cholecystitis on the basis of gallbladder adenomyomatosis with gallstones. Surgical resection was performed after exclusion of pancreatic carcinoma and the resected speciemen showed a white colored and thickened wall of the gallbladder with a smooth surface. Histopathological examination showed a marked fibrosis and scattered abscesses of the subserosal layer of the gallbladder with dilated Rokitansky-Ashoff sinuses without malignancy. The gallbladder lesion was diagnosed as chronic cholecystitis. Our case suggested the mucosal line could play an important role in differentiation of chronic cholecystitis from gallbladder carcinoma.
