Gallbladder lymphoma is exceedingly rare and presents diagnostic challenges due to its imaging characteristics often resembling those of gallbladder adenocarcinoma.
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Epidemiology
Primary lymphomas of the gallbladder are extremely rare, accounting for approximately 0.1-0.2% of all malignant tumors affecting the gallbladder 2.
Diagnosis
Histopathology with immunohistochemistry are essential for confirming the diagnosis 3.
Clinical presentation
Most patients with primary gallbladder lymphoma present with acute cholecystitis or obstructive jaundice 2.
Pathology
Primary lymphoma of the gallbladder refers to an extranodal non-Hodgkin lymphoma originating within the gallbladder, predominantly localized to this site. While lymph node involvement and distant spread may occur, clinical presentation typically centers on the gallbladder, with treatment primarily targeted at this area 4.
The presence of secondary lymphoma of the gallbladder can be suspected when there is involvement of other organs and lymph nodes 1.
Radiographic features
High-grade lymphomas typically manifest as solid lesions or irregular wall thickening within the gallbladder, while low-grade lymphomas may present with mild gallbladder wall thickening 1. Unlike gallbladder adenocarcinoma, which mainly affects the epithelium, lymphomas typically involve the submucosa, possibly sparing the adjacent intact mucosa 1. MRI often show low signal intensity on T1-weighted images and high signal intensity on T2-weighted images 1.
Treatment and prognosis
Management usually includes cholecystectomy and chemotherapy, with or without radiotherapy.
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