Department of Pathology and Immunology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA 63110.
Department of Pathology and Immunology, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA 63110.
Hum Pathol. 2019 Jun;88:1-6. doi: 10.1016/j.humpath.2019.03.003. Epub 2019 Apr 1.
Follicular cholecystitis (FC) is a relatively rare entity with uncertain causal associations. In this study, we aimed to explore different clinicopathologic associations of FC, and to better characterize the entity. A retrospective review of archival hematoxylin and eosin slides and pertinent clinical information was undertaken for all cholecystectomy cases with a rendered diagnosis of "follicular cholecystitis," from 1991 to 2017. Concurrent conventional chronic cholecystitis (CC) and lymphocytic cholecystitis (LC) were documented. Forty-three consecutive patients were confirmed to have FC. The majority of the patients (88.4%) had at least one other histologic association in the gallbladder (LC, CC, or both). Remarkably, functional distal biliary obstruction (from choledocholithiasis, sclerosing cholangitis, distal biliary strictures, or malignancies of the pancreatic head or ampulla) was found in 76.7% of the patients, irrespective of the presence of other concurrent histologic findings. FC associated with CC was relatively more common in females (61%) and strongly associated with cholelithiasis (70%). However, those without CC were predominantly males (70%) and had a significant association with LC (75%). All four cases of FC without any other histologic associations who had clinical information available showed some form of distal biliary obstruction. FC cases without concurrent LC were often associated with CC (74%). FC is strongly associated with extrahepatic biliary obstruction distal to the gallbladder. Therefore, this finding at routine cholecystectomy may warrant further evaluation to rule out a cause for distal biliary tract obstruction. Additionally, it is commonly associated with other concomitant histologic abnormalities in the gallbladder such as CC and/or LC.
滤泡性胆囊炎（FC）是一种相对罕见的疾病，其病因尚不明确。本研究旨在探讨 FC 的不同临床病理关联，以便更好地描述这种疾病。我们对 1991 年至 2017 年间所有胆囊切除术病例的存档苏木精-伊红切片和相关临床资料进行了回顾性分析，这些病例的诊断均为“滤泡性胆囊炎”。同时记录了并发的常规慢性胆囊炎（CC）和淋巴细胞性胆囊炎（LC）。共确诊 43 例连续的 FC 患者。大多数患者（88.4%）的胆囊还存在其他组织学关联（LC、CC 或两者均有）。值得注意的是，76.7%的患者存在功能性远端胆道梗阻（由胆总管结石、硬化性胆管炎、远端胆管狭窄或胰头或壶腹恶性肿瘤引起），而不论是否存在其他并发的组织学发现。与 CC 相关的 FC 在女性中相对更为常见（61%），且与胆石症密切相关（70%）。然而，那些没有 CC 的患者主要为男性（70%），且与 LC 显著相关（75%）。在有临床资料可查的 4 例无其他组织学关联的 FC 患者中，均存在某种形式的远端胆道梗阻。无 LC 并发的 FC 病例常与 CC 相关（74%）。FC 与胆囊外的肝外胆道远端梗阻密切相关。因此，在常规胆囊切除术中发现这一结果可能需要进一步评估，以排除远端胆道梗阻的原因。此外，它常与胆囊内的其他并发组织学异常相关，如 CC 和/或 LC。
