Multiple Minute Gallbladder Muscle Calcifications.

Abstract

We have read with great interest the article of Iqbal et al reporting cases of porcelain gallbladder.[1] Most reported cases show calcifications when at an extensive stage or of bone metaplasia type.[2] [3] However, other types of calcifications can be detected in the gallbladder wall, for example, intracellular epithelial mucosal calcifications in chronic cholecystitis.[4] We would like to draw attention on another type of gallbladder calcifications that of multiple, minute, muscle layer calcifications ([Fig. 1]). Most calcifications were situated between the muscle cells or between muscle cells and the connective tissue (fibrotic or not) of the muscle layer. Some calcifications were situated in zone of muscle granular degeneration/dystrophia and at contact to capillary walls (without calcifications in arteries or veins). The number of reactive lymphocytes was not increased at contact. The gallbladder wall showed mild subacute and chronic cholecystitis.