Follicular cholecystitis with cholelithiasis – A diagnostic pitfall

Authors : Neha M Bhosale, Neha M Bhosale, Mahendra Atmaram Patil, Mahendra Atmaram Patil, Vaishali J Pol, Vaishali J Pol, Jaydeep N Pol, Jaydeep N Pol

DOI : 10.18231/j.jdpo.2021.067

Volume : 6

Issue : 4

Year : 2021

Page No : 316-318

Follicular Cholecystitis (FC) is an extremely rare subtype of Chronic Cholecystitis (CC). It is characterized by hyperplastic lymphoid follicles along with prominent germinal centers. It constitutes about 2% of routine cholecystectomies. In this article, we report a case of FC in a 69 years lady. She had abdominal pain, clinically diagnosed as Calculus cholecystitis and managed by laparoscopic cholecystectomy. Grossly, thickening of the gall bladder wall was noted. Histopathological examination revealed gall bladder wall infiltrated by dense lymphoid infiltrate forming lymphoid follicles with prominent germinal centres. Hence, we rendered a diagnosis of FC. The purpose of presenting this case is to make pathologists aware about this entity. One should not mistake this lesion for lymphoma. A careful histopathological examination is diagnostic and Immunohistochemistry may be helpful in difficult cases.
Key Messages: Follicular Cholecystitis is extremely rare variant of Chronic cholecystitis. It is characterized by at least 3 Lymphoid Follicles per cm of Gall Bladder tissue with inflammatory infiltrate composed almost exclusively of scattered well-formed Lymphoid Follicles. Pathologist must be familiar with this entity to avoid misdiagnosis of lymphoma.
 

Keywords: Follicular Cholecystitis, Gall Bladder, Lymphoid follicles, Hyperplastic


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