Adenomyomas of the gallbladder: An analysis of frequency, clinicopathologic associations, and relationship to carcinoma of a malformative lesion Journal Article


Authors: Dursun, N.; Memis, B.; Pehlivanoglu, B.; Taskin, O. C.; Okcu, O.; Akkas, G.; Bagci, P.; Balci, S.; Saka, B.; Araya, J. C.; Bellolio, E.; Roa, J. C.; Kee-Taek, J.; Losada, H.; Maithel, S. K.; Sarmiento, J.; Reid, M. D.; Jin-Young, J.; Cheng, J. D.; Basturk, O.; Koshiol, J.; Adsay, N. V.
Article Title: Adenomyomas of the gallbladder: An analysis of frequency, clinicopathologic associations, and relationship to carcinoma of a malformative lesion
Abstract: Context.-- The nature and associations of gallbladder (GB) "adenomyoma" (AM) remain controversial. Some studies have attributed up to 26% of GB carcinoma to AMs. Objective.-- To examine the true frequency, clinicopathologic characteristics, and neoplastic changes in GB AM. Design.-- Cholecystectomy cohorts analyzed were 1953 consecutive cases, prospectively with specific attention to AM; 2347 consecutive archival cases; 203 totally embedded GBs; 207 GBs with carcinoma; and archival search of institutions for all cases diagnosed as AM. Results.-- Frequency of AM was 9.3% (19 of 203) in totally submitted cases but 3.3% (77 of 2347) in routinely sampled archival tissue. A total of 283 AMs were identified, with a female to male ratio = 1.9 (177:94) and mean size = 1.3 cm (range, 0.3-5.9). Most (96%, 203 of 210) were fundic, with formed nodular trabeculated submucosal thickening, and were difficult to appreciate from the mucosal surface. Four of 257 were multifocal (1.6%), and 3 of 257 (1.2%) were extensive ("adenomyomatosis"). Dilated glands (up to 14 mm), often radially converging to a point in the mucosa, were typical. Muscle was often minimal, confined to the upper segment. Nine of 225 (4%) revealed features of a duplication. No specific associations with inflammation, cholesterolosis, intestinal metaplasia, or thickening of the uninvolved GB wall were identified. Neoplastic change arising in AM was seen in 9.9% (28 of 283). Sixteen of 283 (5.6%) had mural intracholecystic neoplasm; 7 of 283 (2.5%) had flat-type high-grade dysplasia/carcinoma in situ. Thirteen of 283 cases had both AM and invasive carcinoma (4.6%), but in only 5 of 283 (1.8%), carcinoma arose from AM (invasion was confined to AM, and dysplasia was predominantly in AM). Conclusions.-- AMs have all the features of a malformative developmental lesion, and may not show a significant muscle component (ie, the name "adeno-myoma" is partly a misnomer). While most are innocuous, some pathologies may arise in AMs, including intracholecystic neoplasms, flat-type high-grade dysplasia or carcinoma in situ, and invasive carcinoma (1.8%, 5 of 283). It is recommended that gross examination of GBs include serial slicing of the fundus for AM detection and total submission if one is found.
Journal Title: Archives of Pathology & Laboratory Medicine
Volume: 148
Issue: 2
ISSN: 0003-9985
Publisher: College of American Pathologists  
Date Published: 2024-02-01
Start Page: 206
End Page: 214
Language: English
DOI: 10.5858/arpa.2022-0379-OA
PROVIDER: EBSCOhost
PROVIDER: cinahl
PUBMED: 37134225
DOI/URL:
Notes: Accession Number: 175180325 -- Entry Date: In Process -- Revision Date: 20240203 -- Publication Type: Journal Article -- Journal Subset: Allied Health; Biomedical; Peer Reviewed; USA -- NLM UID: 7607091. -- Source: Cinahl
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  1. Olca Basturk
    352 Basturk