Fig. 1

Preoperative imaging. (A) Chest CT revealed a calcified, patchy, and striate lesion in the upper lobe of the right lung. (B) Increased lung markings and pleural thickening were observed in both lungs. (C) Multiple mediastinal lymph nodes were identified, with some appearing enlarged and exhibiting slightly higher density. (D) Abdominal CT demonstrated bile stasis in the gallbladder, with a suspected small low-density stone at the gallbladder neck, accompanied by central punctate calcifications. (E) The omentum and mesentery appeared slightly thickened with small patchy shadows. (F) Thickening of the right peritoneum was noted, with scattered calcified foci. (G) Abdominal MRI showed multiple small punctate hyperintense foci on the gallbladder surface on T2-weighted imaging, along with a small, round, low-signal filling defect in the gallbladder neck, consistent with a stone. (H) A local discontinuity of the posterior gallbladder wall suggested a micro-perforation. (I) Coronal MRI revealed the stone located in the gallbladder neck region, accompanied by punctate T2 hyperintense foci on the gallbladder surface