Synchronous but separate neuroendocrine tumor and high-grade dysplasia/adenoma of the gall bladder: A case report

Figure 1  Magnetic resonance cholangiopancreatography showed a long-segmented luminal stricture in the distal common bile duct (arrows).

Figure 2 Evolutionary change in gall bladder polyp. A: A 1-cm hyperechoic lesion with hypoechoic component (polyp) at the gall bladder wall (arrow); B: The polyp became larger compared to its size 1 year prior (arrow); C: The polyp became hypoechoic (arrow) after another 6 mo; D: Ultrasound performed just before surgery revealed a Doppler signal (arrowhead) within the tumor (arrow).

Figure 3  Contrast magnetic resonance imaging T2-weighted images revealed a 2-cm tumor near the gall bladder neck (arrow).

Figure 4  Surgical specimen revealed a 2-cm polypoid tumor mass (arrows) at the gall bladder neck.

Figure 5 Postsurgical findings. A: Tubulo-villous adenoma with high-grade dysplasia (arrows); B: Gall bladder neuroendocrine tumor (GB-NET), 2 mm × 2 mm in dimension (arrows, hematoxylin and eosin staining); C: The tumor cells were positive for cluster of differentiation 56 (arrows); D: GB-NET, grade 2, Ki-67 index: 3%-5%, < 2 mitoses per 10 high-power fields (arrows).