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AM-associated ICNs, composed of mural cystically dilated glands containing florid papillary proliferations lined by mucinous and\/or overtly dysplastic epithelium, are very rare and poorly characterized. This study aimed at investigating the clinico-radiologic, phenotypic\/immunophenotypic, and molecular features of a mono-institutional case series of four AM-ICNs (0.2% of cholecystectomies). Immunohistochemistry for CDX2, MUC2, MUC5AC, MUC6, MUC1, HER2, \u00df-catenin, and p53, as well as next-generation sequencing of 110 tumor-related genes (AmoyDx\u00ae Comprehensive Panel), were performed. Our study confirms the AM-ICN-associated clinico-demographic characteristics previously described, including the relatively low frequency of associated invasive carcinoma (one case, 25%), although high-grade dysplasia (HGD) was observed in three out of four cases. In two cases, imaging findings suspicious for neoplasm were seen. Segmental-type AM was seen in two cases. Predominantly cell phenotype was gastric foveolar in two AM-ICNs and pancreatobiliary in the other two cases (both with HGD), while the immunophenotype was hybrid\/mixed in all cases. No case had nuclear \u00df-catenin expression nor Wnt pathway or <jats:italic>KRAS<\/jats:italic> gene alterations. One case showed both <jats:italic>HER2<\/jats:italic> point mutation and <jats:italic>HER2<\/jats:italic> amplification, while the AM-ICN associated with an invasive adenocarcinoma harbored <jats:italic>TP53<\/jats:italic> mutation and p53 overexpression. In conclusion, our findings suggest the separation of AM-ICNs from other gallbladder dysplastic lesions.<\/jats:p>","DOI":"10.1007\/s00428-025-04077-7","type":"journal-article","created":{"date-parts":[[2025,3,22]],"date-time":"2025-03-22T12:56:52Z","timestamp":1742648212000},"page":"153-162","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Adenomyoma\/adenomyomatosis-associated mural intracholecystic neoplasms: analysis of clinico-pathologic, imaging, and molecular features of a consecutive case series"],"prefix":"10.1007","volume":"487","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2976-7032","authenticated-orcid":false,"given":"Alessandro","family":"Vanoli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Travaglino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Minetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gallotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Grillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Corallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Maestri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Peri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Fugazzola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Antoci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Riboni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Di Sabatino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ansaloni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pietrabissa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioacchino","family":"D\u2019Ambrosio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Paulli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,21]]},"reference":[{"key":"4077_CR1","doi-asserted-by":"publisher","first-page":"206","DOI":"10.5858\/arpa.2022-0379-OA","volume":"148","author":"N Dursun","year":"2024","unstructured":"Dursun N, Memis B, Pehlivanoglu B, Taskin OC, Okcu O, Akkas G, Bagci P, Balci S, Saka B, Araya JC, Bellolio E, Roa JC, Jang KT, Losada H, Maithel SK, Sarmiento J, Reid MD, Jang JY, Cheng JD, Basturk O, Koshiol J, Adsay NV (2024) Adenomyomas of the gallbladder: an analysis of frequency, clinicopathologic associations, and relationship to carcinoma of a malformative lesion. 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All information regarding human material was managed using anonymous numerical codes, and all samples were handled in compliance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}