Paraganglia of the gallbladder: a report of two cases with an immunohistochemical study

Paraganglionic tissues incidentally observed in the gallbladder are presented. The patients, a 51- and a 55-year-old woman, underwent gallbladder resection for chronic cholecystitis with gallstones. Two and one paraganglionic tissues were observed in the subserosal connective tissue of the two gallbladders, respectively. Immunohistochemically, the chief cells were positive for chromogranin A, and the sustentacular cells were positive for S100 protein. Tyrosine hydroxylase (in two of three), dopamine beta-hydroxylase (in one of three), methionine-enkephalin (in two of three), and leucine-enkephalin (in two of three) were also positive in a small amount of the chief cells. These structures, which slightly resembled adrenal medulla or retroperitoneal paraganglia, might be misunderstood as an infiltration of primary or metastatic carcinoma into the subserosal connective tissue.