Coronary Artery Disease and Gallbladder Inflammatory Pseudopolyps

Area of Science:

• Gastroenterology
• Radiology
• Pathology

Background:

• Gallbladder polyps are common, but inflammatory pseudopolyps are a rare subtype.
• Differentiating pseudopolyps from neoplastic lesions can be diagnostically challenging.
• Acalculous cholecystitis presents unique diagnostic considerations for gallbladder lesions.

Purpose of the Study:

• To report a case of gallbladder inflammatory pseudopolyps in a patient with acute acalculous cholecystitis.
• To highlight the diagnostic challenges in distinguishing inflammatory pseudopolyps from tumors.
• To emphasize the role of imaging and histology in diagnosing this rare entity.

Main Methods:

• A 78-year-old male with coronary artery disease presented with fever and emesis.
• Computed tomography (CT) revealed signs of acute acalculous cholecystitis.
• Magnetic resonance (MR) imaging demonstrated multiple contrast-enhancing polypoid lesions in the gallbladder.

Main Results:

• MR imaging features, combined with clinical presentation, suggested an inflammatory origin for the polyps.
• Cholecystectomy was performed, and histological examination confirmed gallbladder inflammatory pseudopolyps.
• This condition accounts for 5-10% of all gallbladder polyps.

Conclusions:

• Gallbladder inflammatory pseudopolyps can mimic neoplastic lesions, necessitating careful evaluation.
• Accurate differentiation is critical, especially in the context of acalculous cholecystitis.
• Surgical intervention is often indicated due to diagnostic uncertainty and potential for malignancy.