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Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings

INTRODUCTION AND IMPORTANCE: Follicular cholecystitis (FC) is a rare entity found, it is found in 0.1–1 % of patients with chronic cholecystitis. 1,2 This pathologic finding has been associated with extrahepatic biliary obstruction distal to the gallbladder, such as primary sclerosing cholangitis, c...

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Autores principales: Piening, Nicholas, Zussman, Rachel, Markewycz, Hanna, Piening, Cole, Rossi, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482969/
https://www.ncbi.nlm.nih.gov/pubmed/36058158
http://dx.doi.org/10.1016/j.ijscr.2022.107571
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author Piening, Nicholas
Zussman, Rachel
Markewycz, Hanna
Piening, Cole
Rossi, Thomas
author_facet Piening, Nicholas
Zussman, Rachel
Markewycz, Hanna
Piening, Cole
Rossi, Thomas
author_sort Piening, Nicholas
collection PubMed
description INTRODUCTION AND IMPORTANCE: Follicular cholecystitis (FC) is a rare entity found, it is found in 0.1–1 % of patients with chronic cholecystitis. 1,2 This pathologic finding has been associated with extrahepatic biliary obstruction distal to the gallbladder, such as primary sclerosing cholangitis, choledocholithiasis, and distal biliary strictures. CASE PRESENTATION: Our patient is a 32-year-old female with a past medical history significant for obesity presented with symptoms of postprandial nausea and spasmodic abdominal pain. An abdominal ultrasound was performed with findings adenomyosis and possible gallbladder polyps or adherent stones. The patient was referred to surgery and a routine laparoscopic cholecystectomy with liver biopsy was performed. On pathology, the gallbladder was found to have chronic, active follicular cholecystitis with cholelithiasis. Percutaneous needle liver biopsy revealed the following: focal, mild periductal fibrosis, mild portal fibrosis with minimal mixed micro- and macrovesicular steatosis, and no significant steatohepatitis. CLINICAL DISCUSSION: To the best of our knowledge, this is the first documented case of follicular cholecystitis with associated hepatic findings on pathology. Follicular cholecystitis is strongly associated with extrahepatic biliary obstruction distal to the gallbladder, but it has not been previously associated with liver fibrosis. We hope to bring awareness to this rare but significant pathology. CONCLUSION: Our case is unusual due to the findings of hepatic periductal fibrosis with follicular cholecystitis. Follicular cholecystitis is strongly associated with extrahepatic biliary obstruction distal to the gallbladder but it has not been documented it to be associated with any hepatic findings or pathology.
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spelling pubmed-94829692022-09-20 Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings Piening, Nicholas Zussman, Rachel Markewycz, Hanna Piening, Cole Rossi, Thomas Int J Surg Case Rep Case Report INTRODUCTION AND IMPORTANCE: Follicular cholecystitis (FC) is a rare entity found, it is found in 0.1–1 % of patients with chronic cholecystitis. 1,2 This pathologic finding has been associated with extrahepatic biliary obstruction distal to the gallbladder, such as primary sclerosing cholangitis, choledocholithiasis, and distal biliary strictures. CASE PRESENTATION: Our patient is a 32-year-old female with a past medical history significant for obesity presented with symptoms of postprandial nausea and spasmodic abdominal pain. An abdominal ultrasound was performed with findings adenomyosis and possible gallbladder polyps or adherent stones. The patient was referred to surgery and a routine laparoscopic cholecystectomy with liver biopsy was performed. On pathology, the gallbladder was found to have chronic, active follicular cholecystitis with cholelithiasis. Percutaneous needle liver biopsy revealed the following: focal, mild periductal fibrosis, mild portal fibrosis with minimal mixed micro- and macrovesicular steatosis, and no significant steatohepatitis. CLINICAL DISCUSSION: To the best of our knowledge, this is the first documented case of follicular cholecystitis with associated hepatic findings on pathology. Follicular cholecystitis is strongly associated with extrahepatic biliary obstruction distal to the gallbladder, but it has not been previously associated with liver fibrosis. We hope to bring awareness to this rare but significant pathology. CONCLUSION: Our case is unusual due to the findings of hepatic periductal fibrosis with follicular cholecystitis. Follicular cholecystitis is strongly associated with extrahepatic biliary obstruction distal to the gallbladder but it has not been documented it to be associated with any hepatic findings or pathology. Elsevier 2022-09-01 /pmc/articles/PMC9482969/ /pubmed/36058158 http://dx.doi.org/10.1016/j.ijscr.2022.107571 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Piening, Nicholas
Zussman, Rachel
Markewycz, Hanna
Piening, Cole
Rossi, Thomas
Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings
title Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings
title_full Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings
title_fullStr Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings
title_full_unstemmed Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings
title_short Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings
title_sort incidental follicular cholecystitis with periductal fibrosis on liver biopsy: rare findings
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9482969/
https://www.ncbi.nlm.nih.gov/pubmed/36058158
http://dx.doi.org/10.1016/j.ijscr.2022.107571
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