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From the Archives of the AFIP

Benign Tumors and Tumorlike Lesions of the Gallbladder and Extrahepatic Bile Ducts: Radiologic-Pathologic Correlation¹

¹ From the Departments of Radiologic Pathology (A.D.L.) and Hepatic and Gastrointestinal Pathology (L.A.M.), Armed Forces Institute of Pathology, Room M-121, Alaska and Fern Sts, NW, Washington, DC 20306-6000; Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (A.D.L., R.M.A); Department of Radiology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, Tex (R.M.A.); and Department of Radiology, University of Washington, Seattle (C.A.R.). Received August 15, 2001; revision requested September 24 and received October 17; accepted October 19. Address correspondence to A.D.L. (e-mail: levya@afip.osd.mil).

A diverse spectrum of benign tumors and tumorlike lesions arises from the gallbladder and bile ducts, and despite their diversity, these lesions share common embryologic origins and histologic characteristics. Although these lesions are relatively uncommon, their importance lies in their ability to mimic malignant lesions in these locations. Benign neoplasms are derived from the epithelial and nonepithelial structures that compose the normal gallbladder and bile ducts. The epithelium gives rise to adenomas, cystadenomas, and the unusual condition of biliary papillomatosis. Granular cell tumors, neurofibromas, ganglioneuromas, paragangliomas, and leiomyomas are examples of benign tumors that may originate from nonepithelial structures. Tumorlike lesions are more commonly found in the gallbladder and include xanthogranulomatous cholecystitis, adenomyomatous hyperplasia, cholesterol polyps, and heterotopias. In the clinical setting of a patient with nonspecific abdominal complaints or symptoms of biliary obstruction, the discovery of a gallbladder or bile duct polyp or mass, gallbladder wall thickening, or biliary stricture is most often indicative of malignancy. However, the differential diagnosis should include benign tumors and tumorlike lesions. The preoperative determination of a benign lesion may significantly alter therapy and patient prognosis.

Index Terms: Bile ducts, neoplasms, 768.31 • Gallbladder, neoplasms, 768.31

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