Flat-elevated gallbladder tumor with a deep hypoechoic area except T2 carcinoma

What is it about?

Commonly, a polypoid or flat-elevated gallbladder tumor with a deep hypoechoic area suggests an adenocarcinoma invading the subserosa. However, the histopathology of this case indicated chronic cholecystitis: an inflammatory nodule consisting of dense inflammatory cell infiltrates and massive fibrosis beneath the epithelium of the Rokitansky-Aschoff sinus almost filled with secretions in the shallow subserosa.

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Photo by James Wainscoat on Unsplash

Photo by James Wainscoat on Unsplash

Why is it important?

Although a polypoid gallbladder tumor with a deep hypoechoic area suggests an adenocarcinoma invading subserosa, accompanied by abundant fibrosis and lymphocytic infiltration, a particular benign protruded lesion may rarely show a deep hypoechoic area, corresponding to only massive fibrosis without an adenocarcinoma invading subserosa. Likewise, a flat-elevated gallbladder lesion with a deep hypoechoic area should be kept in mind to detect a T2 GBC. However, a specific benign flat-elevated lesion may rarely show similar ultrasound findings to T2 carcinoma as in this case.

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