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Clinical/pathological analysis of gallbladder adenomyomatosis

Authors
Kim, JH; Jeong, IH; Han, JH; Hwang, JC; Yoo, BM; Kim, MW; Kim, WH
Citation
Hepato-gastroenterology, 57(99-100):420-425, 2010
Journal Title
Hepato-gastroenterology
ISSN
0172-6390
Abstract
BACKGROUND/AIMS: The aim of this study was to analyze the clinical/pathological outcomes of patients that underwent surgery for gallbladder adenomyomatosis, to clarify the characteristics of the type and pathogenesis of adenomyomatosis.



METHODOLOGY: From May 1997 to March 2008, 4704 consecutive patients underwent cholecystectomy at Ajou University Medical Center. Among them, 113 (2.4%) patients that were histopathologically diagnosed with adenomyomatosis or adenomatous hyperplasia were selected for this study. The patients were divided into a fundal type group and a segmental/diffuse type group, and the specimens reviewed with Hematoxylin-Eosin (H & E) and immunohistochemical stainings.



RESULTS: Sixty-three patients were male and 50 female; the age ranged from 17 to 76 years of age. The fundal type was the most common type. Gallstones were present in 69.9% of the patients. In the analysis of the fundal and segmental/diffuse types, gallstones were present in 23 patients with fundal type and in 53 patients with segmental/diffuse type; this difference was statistically significant (p < 0.05). Review of H & E staining showed that the most common findings were grade 1 (n = 14) in the fundal type and grade 2 (n = 23) in the segmental/diffuse type; there was a significant difference in the inflammatory grade (p < 0.05). Immunohistochemical staining showed expression of vimentin, as a mesenchymal marker in 28.0% of cases (n = 16).



CONCLUSIONS: The fundal type differed from the segmental/diffuse type based on the clinical/ pathological features; it had a lower frequency of gallstones and a lower inflammatory grade. In addition, no cancer was identified in the resected gallbladders of patients with adenomyomatosis. The findings suggest that the Rokitansky-Aschoff sinuses (RAS) were associated with acquired motility, based on the expression of vimentin, consistent with an epithelial-mesenchymal transition.
MeSH terms
Adenomyoma/etiologyAdenomyoma/pathology*Adenomyoma/surgeryAdolescentAdultAgedEpithelial Cells/pathologyFemaleGallbladder Neoplasms/etiologyGallbladder Neoplasms/pathology*Gallbladder Neoplasms/surgeryGallstones/etiologyHumansMaleMesoderm/pathologyMiddle Aged
PMID
20698201
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
AJOU Authors
김, 지훈한, 재호김, 장희황, 재철유, 병무김, 진홍김, 명욱김, 욱환
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