Follicular Cholecystitis: A Case Report Highlighting the Diagnostic Challenges and Management Implications

Abstract

Follicular cholecystitis (FC), a rare benign entity, represents <2% of cholecystectomies. We present imaging findings and immunohistochemistry used for diagnosis in an 82-year-old Thai female presenting with persistent colicky biliary pain. Upper abdomen magnetic resonance imaging revealed a gallstone and mild asymmetric gallbladder wall thickening. Diagnosed with symptomatic gallstones, she underwent laparoscopic cholecystectomy. Gross pathology indicated multiple nodules (0.1–0.5 cm) at the gallbladder fundus. Histopathological examination revealed transmural nodular lymphoid proliferation, suggesting a lymphoproliferative disorder or lymphoma. Subsequent immunohistochemistry led to a FC diagnosis. FC presents a significant diagnostic challenge and requires accurate pathological diagnosis to avoid unnecessary cancer treatments.