Heterotopic gastric mucosa together with intestinal metaplasia and moderate dysplasia in the gall bladder: report of two clinically unusual cases with literature review

We report the clinicopathological findings of two patients with ectopic gas tric mucosa within the gall ladder. The first patient, a 78 year old man, w as asymptomatic. He was admitted to hospital for a colon adenocarcinoma. In traoperatively, a firm nodule was palpable in the gall bladder. Histologica l examination of the resected specimen revealed a body type gastric mucosa in the submucosa, adjacent to which were extensive pyloric gland and intest inal metaplasia with mild to moderate dysplasia. The remaining gall bladder mucosa demonstrated changes of chronic cholecystitis. The second patient w as a 62 year old woman with symptoms of chronic cholecystitis. The preopera tive diagnosis was consistent with this diagnosis with a "polyp" at the jun ction of the neck and cystic duct. Cholecystectomy was performed and the hi stological examination of the resected specimen showed that the ((polyp)) c onsisted of heterotopic gastric mucosa with glands of body and fundus type. In the remaining mucosa, chronic cholecystitis was evident. To the best of our knowledge, this is the first report of a clinicopathological presentat ion of heterotopic gastric mucosa, pyloric gland type, and intestinal metap lasia with dysplastic changes in the gall bladder. As heterotopic tissue ma y promote carcinogenesis of the gall bladder, close attention should be pai d to any occurrence of such lesions in this anatomical region.