Gallbladder Polyp-An Incidental Finding of a High-grade B-cell Lymphoma: A Case Report.

Abstract

Introduction and importance: High-grade B-cell lymphoma (HGBCL) is a highly aggressive form of B-cell non-Hodgkin lymphoma. Lymphoma involvement of the gallbladder is rare, with a reported incidence of 0.1-0.2%.

Case description: In this report, we introduce the first case of a high-grade lymphoma presented as an asymptomatic gallbladder polyp in a 78-year-old woman. A preoperative computed tomography (CT) scan showed findings consistent with a possible mass-like lesion measuring 10 × 10 mm adjacent to the gallbladder and a cirrhotic liver. According to those findings, the decision was made to perform a laparoscopic cholecystectomy with an intraoperative cholangiogram. Histological examination of the excised mass showed a neoplastic proliferation of lymphocytes consistent with HGBCL.

Discussion: This rare entity can present as common symptomatic cholecystitis or an asymptomatic mass with insidious growth. In this case, it was an incidental finding on imaging, which leads us to emphasize the importance of imaging studies as the first approach in the diagnosis of this uncommon extranodal lymphoma located within the gallbladder. Surgical excision with subsequent histopathological evaluation is the gold standard for a correct and prompt diagnosis.

Conclusion: Gallbladder lymphoma is a rare condition with a challenging diagnosis. Although the prognosis is favorable in most cases, chemotherapy or radiotherapy may be necessary for remission of the disease.