To the Editor.—In the discussion of their well-documented case of paraganglioma of the gallbladder (Arch Surg 105:637-639, 1972) Miller and co-authors stated that nonneoplastic paraganglionic tissue had not as yet been described in the gallbladder.
In the Laboratory of Surgical Pathology at the College of Physicians and Surgeons, we have observed paraganglia in the wall of the gallbladder on three occasions in recent years. In each instance cholecystectomy had been performed for chronic cholecystitis with cholelithiasis. All three patients were women and their ages were 32, 52, and 59 years, respectively. The paraganglionic tissue was always in the subserosal layer and always in close proximity to nerve fibers and ganglion cells, although occasionally several levels through the tissue block were required to demonstrate this spatial relationship (Figure).
Thus, the neoplasm reported by Miller et al could well have arisen from preexisting paraganglionic tissue; furthermore, the position of the tumor