Intracholecystic Papillary Neoplasm with Low-grade Intraepithelial Neoplasia: A Rare Entity

Abstract

Intracholecystic Papillary Neoplasm (ICPN) is a recently described, rare, mass forming, epithelial neoplasm originating in the mucosa of the gall bladder. It usually protrudes in the lumen and is generally noninvasive but may show dysplastic changes which may be low-grade or high-grade or may be associated with invasive carcinoma. Authors hereby describe a case of ICPN in a 57-year-old female patient who reported to Surgery Outpatient Department (OPD) with the chief complaint of pain in abdomen since last five days. On ultrasonography, gall stones were detected for which she underwent cholecystectomy. Histopathological Examination (HPE) revealed a papillary growth in the body of gall bladder measuring 1.0 cm in diameter. Sections from the growth showed back-to-back arranged glands exhibiting a papillary pattern. The glands were lined by columnar epithelium with basally located nuclei. Pyloric metaplasia was noted focally. No foci of invasion were seen. Papillary hyperplasia was noted in adjacent areas along with features consistent with chronic cholecystitis. Thus, a diagnosis of ICPN with low-grade intraepithelial neoplasia was made. The patient recovered well postsurgery and is on regular follow-up.