Tae-Young Kim 1 2, Ye-In Oh 2
Background
Porcelain gallbladder (PGB) is an extremely rare condition in dogs, marked by extensive calcification and fibrosis of the gallbladder wall. Its etiology remains unclear, but it is often associated with chronic cholecystitis, mucin hypersecretion, biliary obstruction, and gallbladder mucocele. While the association between PGB and gallbladder carcinoma is debated in human medicine, limited veterinary literature exists. The present report aims to describe the clinical presentation, diagnostic imaging, surgical findings, and histopathological characteristics of PGB in a dog with concurrent gallbladder mucocele.
Methods
This case involved a 13-year-old spayed female Shih Tzu presented with anorexia, vomiting, lethargy, and weight loss. Laboratory tests assessed liver function, lipid levels, endocrine status, and inflammation. Diagnostic imaging included radiography, ultrasonography, and CT. Surgical cholecystectomy was performed, with concurrent liver biopsy. Histopathology, special staining (Von Kossa, Masson’s Trichrome), and immunohistochemistry (CD3, PAX5) were used to evaluate gallbladder and liver tissues.
Results
Imaging confirmed severe calcification and thickening of the gallbladder wall, gallstones, bile duct dilation, and signs of pancreatitis and duodenitis. Gross examination revealed a brittle, bluish-gray gallbladder with diffuse calcification and mucoid material in the lumen. Histologically, the gallbladder exhibited severe papillary hyperplasia, mucin hypersecretion, diffuse fibrosis, transmural necrosis, and calcification. Minimal lymphocytic infiltration was observed. Liver biopsy revealed no neoplasia but showed multifocal vacuolar hepatocellular changes. Postoperatively, liver enzyme levels normalized, and the patient showed clinical improvement with no complications over a two-month follow-up.
Limitations
As a single case study, generalizability is limited. The absence of neoplastic findings does not exclude potential future risk, and the chronicity of lesions implies a long-standing subclinical process. The study design does not permit determination of causal relationships between PGB, mucocele, and other systemic conditions.
Conclusions
This case illustrates a rare manifestation of PGB in a dog with concurrent gallbladder mucocele, providing histopathological confirmation and demonstrating successful surgical intervention. The findings suggest chronic bile stasis and mucocele formation may contribute to PGB in the absence of active inflammation or neoplasia. Early recognition and surgical management are critical to prevent complications. Further studies are necessary to elucidate the pathogenesis and clinical implications of PGB in veterinary patients.
Radiograph images of this dog revealed a nearly spherical calcified structure with irregular margins, suggestive of a calcified gallbladder (arrows). The gallbladder shows both linear and floccular calcifications. (A) Right lateral view. (B) Ventrodorsal view. Abdominal ultrasound confirmed the presence of a calcified gallbladder wall characterized by posterior acoustic shadowing in this dog. (C) A biconvex curved echo structure with variable acoustic shadows shows a curvilinear hyperechoic area along the anterior wall (arrow). In contrast, the posterior wall (arrowhead) is mostly obscured by the posterior acoustic shadowing, with only a part being visible. (D) Areas of non-shadowing calcium (arrow) and part of the gallbladder interior are observed. Computed tomography of the dog. (E) An increase in the gallbladder wall thickness (arrow) and extensive wall calcification were observed. Cholelithiasis (arrowhead) was noted within the gallbladder. (F, G) Mild dilation of the common bile duct (arrow), along with dilation of the intrahepatic bile ducts (arrowhead), was observed.
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