Man 26 yo with subhepatic
pain post prandial for a long time.
Ultrasound of abdomen:
US 1=
intercostal scan, liver is normal, biliary tract no dilated, and
gallbladder (GB) adheres in liver border by 2 portions, one
near the GB neck filling by bile fluid and GB fundus covered by
a solid mass with size of 3 cm which is.well limited inside GB.
US 2= Color Doppler
(CDI): no thickening of GB wall, no hypervascular in GB wall, and
no detected vascular supply for this mass. But no posterior shadowing of
this mass with little enhancement of the posterior wall.
US 3= the GB fundus is
covered by this mass but the wall is intact. This mass has no motion.
Sonologist
suggested a tumor of GB like GB adenomyomatosis.
MRI of the biliary
tract.:
MRI 1= the
biliary tract has no stone and GB is filled by tumor at GB fundus.
MRI 2 = GB
has 3 portions, the middle portion is hyperdense and adherent
to liver. The GB wall is thickening like tumor and enhanced with gado.
MRI 3 = crossed
section of the GB at middle portion, GB wall thickening and GB lumen
is small.
Radiolodist report
is tumor of GB.
Laparocholecystectomy
was performed.
Photo 1 =
the GB wall is well intact.
Photo 2,3 =
inside content of material of black pigment like coffee waste. The GB wall is normal without
tumor.
Pathology report is pigment sludge and
inflammation of GB.
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