title: Well-differentiated adenocarcinoma of the gallbladder with intratumoral cystic components due to abundant mucin production: a mimicker of adenomyomatosis.
abstract: The prevalence and etiology of the cystic components within gallbladder carcinomas as seen on MR images were evaluated. A retrospective review of MR images was performed for 35 proven gallbladder carcinomas in search of radiologically detectable intratumoral cystic components. The pathologic specimens were meticulously reviewed to determine the etiology. MR images of 31 adenomyomatoses were also reviewed for comparison to clarify the difference in MR features between these two entities. Three cases out of 35 proven gallbladder carcinomas were found to have intratumoral cystic components. They were all well-differentiated adenocarcinomas, and the cystic components consisted of dilated neoplastic glands filled with abundant mucin pool. Adenomyomatosis tended to have more and rounded cystic components (Rokitansky-Aschoff sinuses) lined in a linear fashion and were flat-elevated in shape, smaller in size and had a regular surface, as compared to the three carcinomas. Although rare, radiologists need to be aware that well-differentiated gallbladder carcinoma with mucin production can have cystic components, which may mimic adenomyomatosis. Careful interpretation of MR images may provide useful information in the differentiation of these two entities.
authors.affiliation: Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi Higashi-ku, Fukuoka, 812-8582, Japan. yoshimitsu@dr.hosp.kyushu-u.ac.jp
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Irie
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Aibe
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tajima
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Asayama
authors.forename: Kunishige
authors.initials: K
authors.lastname: Matake
authors.forename: Kouji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Shuji
authors.initials: S
authors.lastname: Matsuura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology / Q000473:pathology*; D018194:Adenomyoma / Q000473:pathology; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D005706:Gallbladder Neoplasms / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D018709:Statistics, Nonparametric