2022 Volume 36 Issue 1 Pages 47-54
Leukemia presenting as a gallbladder tumor is extremely rare. 70-year-old man who was diagnosed with sternum infectious arthritis was coincidentally found a gallbladder tumor and a left renal tumor by enhanced CT. Preoperative diagnosis was gallbladder carcinoma invading the subserosa. Cholecystectomy accompanied with the gallbladder bed resection and regional lymph node dissection were performed. Histopathological examination revealed that atypical lymphoid cells proliferated diffusely throughout the gallbladder wall, and no atypical cells were found in the gallbladder epithelium. Immunohistochemistry showed TdT (+), CD10 (+), CD79a (+), and Bcl-2 (+). In addition, bone marrow biopsy showed proliferation of atypical cells in about 60% of the tissues, showing an immunostaining pattern similar to that of gallbladder specimens, and the diagnosis was B lymphoblast acute leukemia. PET examination revealed a high accumulation of fluorodeoxyglucose in the bones and left kidney tumors of the whole body, as well as in the para-aortic lymph nodes and uncinate process of pancreas. One course of chemotherapy (HyperCVAD+MA) was performed and a complete metabolic response was obtained. At 15 months after the three courses of chemotherapy, a PET scan showed recurrence of the disease in the bone.
