Hyalinizing Cholecystitis and Associated Carcinoma: A Case Report

Abstract

Hyalinizing cholecystitis (HC) is a recently described rare variant of chronic cholecystitis that is characterized by replacement of the normal structures of the entire gallbladder wall with diffuse and dense hyaline sclerosis.(1) Some cases of cholecystitis are associated with variable degrees of calcification. Porcelain gallbladder (PG) is an extensively calcific example that is a vaguely and radiologically defined entity whose pathologic correlation has not been identified.(2-4) PG is subclassified into "complete porcelain," showing extensive dystrophic calcifications that form an intramural continuous band involving more than 80% of the gallbladder wall, and "incomplete porcelain," which lacks these findings.(2,5-7) Although HC is rare and found in only approximately 1.6% of cholecystectomy specimens, it is more commonly accompanied by carcinomas with more aggressive clinical behavior compared to usual gallbladder carcinomas.(1) However, preoperative diagnosis of HC-related carcinoma is challenging, because the wall is thinner than that of typical chronic cholecystitis or usual carcinomas, and discrete masses are not formed. There has been only one case report of HC, which was accompanied by immunoglobulin G4-related disease,(8) since Patel et al.(1) first described the entity in a retrospective case series. We present a case of HC and associated carcinoma masquerading as primary biliary cancer.