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Case of the Week #234

22 February 2012 - Case of the Week #234

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Thanks to Dr. David Cohen, Herzliyah Medical Center (Israel), for contributing this case. To contribute a Case of the Week, follow the guidelines on our Case of the Week page.

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Website news:

(1) We have added links for free CME from Cleveland Clinic to our CME page, which has a link on the left side of the Home page.

(2) The second half of the Lymphoma and plasma cell neoplasms chapter (T/NK cell disorders, Hodgkin's lymphoma, post-transplant, other) was recently updated based on a review by Dragos C. Luca, M.D., Children's Hospitals & Clinics of Minnesota. The balance of this chapter was updated in early 2011.

(3) Our Feature page for the month highlights Microscopes / slide imaging, and includes Celestron, Leica Microsystems, and Optronics. Also check out our new monthly Mystery Image, on the right side of the Home Page.

Case of the Week #234

Clinical History:

A 29 year old woman had a cholecystectomy (no other clinical information provided).

Micro images:


What is your diagnosis?


Mild, chronic cholecystitis with a focus of metaplastic bone formation in the gallbladder mucosa


Metaplastic bone formation in the gallbladder mucosa is rare (South Med J 2009;102;322), and may clinically simulate cholelithiasis.

Osseous metaplasia is nonspecific. It may be associated with chronic cholecystitis, a cholesterol polyp (South Med J 2009;102:773), a fasciitis-like fibrous proliferation containing scattered osteoclast-like giant cells (Pediatr Dev Pathol 2011;14:80), or with carcinoma (Tumori 1999;85:133). In addition, osteosarcoma must be ruled out (HPB (Oxford) 2006;8:65).

Nat Pernick, M.D., President
and Liz Parker, B.A., Associate Medical Editor
PathologyOutlines.com, Inc.
30100 Telegraph Road, Suite 408
Bingham Farms, Michigan (USA) 48025
Telephone: 248/646-0325
Email: NatPernick@Hotmail.com
Alternate email: NatPernick@gmail.com