Gallbladder granulomas are exceedingly rare, reported in association with tuberculosis or sarcoidosis. Here we report a case of gallbladder granulomatous cholecystitis occurring in the context of sarcoidosis. A 70-years old man presented with abdominal pain, nausea and vomiting. The medical history revealed sarcoidosis diagnosed more than 20-years previously. 2-years previously the patient showed renal lithiasis, hypercalcemia and, increased angiotensin converting enzyme. The imaging features suggested thoraco-abdominal sarcoidosis. Prednisone was given at 1.2 mg/kg/day initially, than decreased, being at 2.5 mg/day at present. The ultrasound examination showed gallbladder lithiasis. A cholecystectomy was performed. Microscopy showed subacute and chronic cholecystitis with several epithelioid and giant cell granulomas some of them perineural. In conclusion, we report a case of granulomatous cholecystitis occurring in the course of treated sarcoidosis. The perineural location of granulomas may give further insights into the pathogenesis of gallbladder dysmotility.
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机译：胆囊肉芽肿极为罕见，据报道与结核或结节病有关。在这里，我们报告一例在结节病的背景下发生的胆囊肉芽肿性胆囊炎。一名70岁的老人出现腹痛，恶心和呕吐。病史显示结节病已被诊断超过20年。两年前，患者表现出肾结石，高钙血症和血管紧张素转化酶升高。影像学特征提示胸腹结节病。刚开始泼尼松的剂量为1.2 mg / kg /天，而目前减少到2.5 mg / kg。超声检查显示胆囊结石。进行了胆囊切除术。显微镜检查显示亚急性和慢性胆囊炎，伴有数个上皮样肉芽肿和巨细胞肉芽肿，其中一些在神经周围。总之，我们报告了在治疗结节病过程中发生肉芽肿性胆囊炎的病例。肉芽肿的神经周围位置可进一步了解胆囊运动障碍的发病机理。
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