case_images: PMC10277686_01
case_images: Female, 69 years old, a year ago, magnetic resonance examination, 1A (T1-weighted images), 1B T2-weighted images), 1C (arterial stage 20s), 1D (portal stage 55s) showed a slight thickening of the gallbladder wall (arrow), mild enhancement, gallbladder sediment stones, no signs of gallbladder tumor.
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case_images: PMC10277686_01_fonc-13-1136876-g001.jpg
case_images: f1
case_images: Alanine aminotransferase 174IU/L , Aspartate aminotransferase 420IU/L , glutamyltransferase 170IU/L , alkaline phosphatase 166IU/L , glucose 7.3mmol/L , lactate dehydrogenase 435IU/L , Creatine kinase isoenzyme 29IU/L , angiotensin converting enzyme 62.3U/L .Blood tumor marker report: CEA (-), AFP (-), CA199 224.50U/mL  .One year ago, the patient underwent magnetic resonance imaging (MRI)examination of the upper abdomen due to abdominal pain, and MRI showed chronic cholecystitis without gallbladder tumor signs ( Figure 1 ). After admission, computed tomography(CT) scan showed increased gallbladder volume, uneven density at the bottom of the gallbladder, fusiform thickening of the gallbladder wall, uneven thickness, and rough edges, suggesting gallbladder neoplastic lesions and high possibility of gallbladder cancer.
case_images: Female, 69 years old.1h after injection of 18F-FDG into PET/CT, 2A (whole body MIP), 2B (axial PET), 2C (axial CT), 2D (axial fusion) showed slightly increased gallbladder volume, uneven thickening of gallbladder bottom, eccentric and limited thickening of gallbladder body wall (arrow), and nodular soft tissue density shadow with a size of about 13x19mm. The hepatobiliary interface was clear, radioactivity uptake increased, and SUVmax was 10.2 (arrow).
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case_images: f2
case_images: PET/CT without MRI, PET/CT showed uneven thickening at the bottom of the gallbladder, slightly increased gallbladder volume, and eccentric and localized thickening of the gallbladder body wall, PET/CT showed nodular soft tissue density shadow, about 13x19mm in size, increased radioactive uptake, SUVmax was 10.2, which was considered to be a high possibility of gallbladder cancer. PET/CT also revealed stenosis of the lower common bile duct, which was considered to be inflammatory ( Figures 2 ,  3 ).
case_images: Female, 69 years old. 3A (coronal CT), 3B (coronal fusion), 3C (sagittal CT), and 3D (sagittal fusion). Imaging was performed 1h after 18F-FDG injection. PET/CT showed eccentric and localized thickening of the gallbladder body wall (arrow), nodular soft tissue density shadow, increased radioactive uptake, and SUVmax was 10.2 (arrow).
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case_images: f3
case_images: PET/CT without MRI, PET/CT showed uneven thickening at the bottom of the gallbladder, slightly increased gallbladder volume, and eccentric and localized thickening of the gallbladder body wall, PET/CT showed nodular soft tissue density shadow, about 13x19mm in size, increased radioactive uptake, SUVmax was 10.2, which was considered to be a high possibility of gallbladder cancer. PET/CT also revealed stenosis of the lower common bile duct, which was considered to be inflammatory ( Figures 2 ,  3 ).
case_images: A 69-year-old woman with an inflammatory pseudotumor of the gallbladder. 4A (HEx40), 4B (HEx100), 4C (HEx200), 4D (HE x400).This image shows localized fibrous connective tissue hyperplasia with extensive chronic inflammatory cell infiltration.
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case_images: f4
case_images: Finally, pathology suggested inflammatory pseudotumor of the gallbladder ( Figure 4 ), Reactive hyperplasia of lymph nodes in group 12A, group 12C, and group 12P.The patient recovered well after surgery and had no significant signs of recurrence after one-year of follow-up.