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N Z Med J. 2007 Mar 23;120(1251):U2470.

Primary diffuse large B-cell lymphoma of the gallbladder with cholelithiasis masquerading as acute cholecystitis: case report and literature review.

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Department of Pathology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung 83305, Taiwan, ROC.


Primary non-Hodgkin lymphoma (NHL) of the gallbladder (GB-NHL) is exceedingly rare. We present our experience on a 78-year-old male with chief complaints of fever, chills, and epigastric dull pain. Abdominal computed tomography (CT) scan showed a few stones and focally thickened gallbladder wall. He received cholecystectomy under the preoperative diagnosis of acute cholecystitis with septic shock, while pathologic examination revealed cholelithiasis and diffuse large B-cell lymphoma without acute inflammation. Staging procedures revealed a stage IE tumour and the patient received adjuvant radiotherapy. Relapse as a large retroperitoneal mass was noted 32 months later and he passed away three years after initial diagnosis. A literature review revealed 20 cases of GB-NHL. We find that, including our current case, the median age is 63 years and 8 of 19 (42%) tumours are associated with gallstones. The mean and median survival of 15 patients with complete follow-up information is 75 and 36 months, respectively. Mucosa-associated lymphoid tissue (MALT) lymphoma seems to carry a longer survival than non-MALT lymphomas.

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