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Hodgkin lymphoma masquerading as perforated gallbladder adenocarcinoma: A case report
- Source :
- World Journal of Gastrointestinal Surgery
- Publication Year :
- 2021
- Publisher :
- Baishideng Publishing Group Inc, 2021.
-
Abstract
- BACKGROUND There are several case reports of acute cholecystitis as the initial presentation of lymphoma of the gallbladder; all reports describe non-Hodgkin lymphoma or its subtypes on histopathology of the gallbladder tissue itself. Interestingly, there is no description in the literature of Hodgkin lymphoma causing hilar lymphadenopathy, inevitably presenting as ruptured cholecystitis with imaging mimicking gallbladder adenocarcinoma. CASE SUMMARY A 48-year-old man with a past medical history of diabetes mellitus presented with progressive abdominal pain, jaundice, night sweats, weakness, and unintended weight loss for one month. Work-up revealed a mass in the region of the porta hepatis causing obstructions of the cystic and common hepatic ducts, gallbladder rupture, as well as retroperitoneal lymphadenopathy. The clinical picture and imaging findings were suspicious for locally advanced gallbladder adenocarcinoma causing ruptured cholecystitis and cholangitis, with metastases to retroperitoneal lymph nodes. Minimally invasive techniques, including endoscopic duct brushings and percutaneous lymph node biopsy, were inadequate for tissue diagnosis. Therefore, this case required exploratory laparotomy, open cholecystectomy, and periaortic lymph node dissection for histopathological assessment and definitive diagnosis. Hodgkin lymphoma was present in the lymph nodes while the gallbladder specimen had no evidence of malignancy. CONCLUSION This clinical scenario highlights the importance of histopathological assessment in diagnosing gallbladder malignancy in a patient with gallbladder perforation and a grossly positive positron emission tomography/computed tomography scan. For both gallbladder adenocarcinoma and Hodgkin lymphoma, medical and surgical therapies must be tailored to the specific disease entity in order to achieve optimal long-term survival rates.
- Subjects :
- Porta hepatis
medicine.medical_specialty
medicine.diagnostic_test
business.industry
Exploratory laparotomy
medicine.medical_treatment
Gallbladder
Gallbladder adenocarcinoma
Lymph node biopsy
Gallbladder perforation
Malignancy
medicine.disease
Surgery
Lymphoma
Acute cholecystitis
medicine.anatomical_structure
hemic and lymphatic diseases
Case report
Cholecystitis
Medicine
business
Hodgkin lymphoma
Subjects
Details
- Language :
- English
- ISSN :
- 19489366
- Volume :
- 13
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- World Journal of Gastrointestinal Surgery
- Accession number :
- edsair.doi.dedup.....65dbbe3d69edede135c50039754de2e6