We describe two patients with autopsy-proven neoplastic angioendotheliomatosis (NAE) presenting only as a transverse myelopathy for 10 to 12 months, followed by disseminated intracranial manifestations. Postmortem examination disclosed a vasculocentric distribution of neoplastic cells in various organs that stained positively with B-lymphocyte-specific monoclonal antibody. These cases were unusual because they manifested as an isolated myelopathy for many months.

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Introduction: During laparoscopic cholecystectomy, an enlarged field of vision increases safety and precision, but surgeons often encounter bleeding that can cause difficulties. It is important to prevent and control arterial bleeding from Calot's triangle and the liver bed that results from injury to the deep branch of the cystic artery (DBCA). However, no previous reports have mentioned the layer between the gallbladder and liver through which the DBCA runs. Materials and Surgical Technique: To determine this layer, we investigated the histological findings from consecutive thin‐slice (3 mm) blocks in six cases (three cadavers and three patients who underwent extended cholecystectomy). Results: The subserosal layer of the gallbladder wall can be divided into an inner (ss‐i) layer, which consists of abundant vasculature and some fibrous tissue, and an outer (ss‐o) layer, which consists of abundant fat tissue. DBCA runs through the ss‐o layer, far from the ss‐i layer in Calot's triangle, and runs toward the gallbladder body and ramifies into several branches that flow into the ss‐i layer. Discussion: If the gallbladder is dissected in the layer close to the ss‐i layer, as in our standardized procedure, the subbranches of DBCA are transected at the border of the ss‐i layer, and most of the DBCA is left within the ss‐o layer in Calot's triangle and the liver bed. Knowledge of the anatomy of DBCA is useful to avoid and stop bleeding from the deep part of Calot's triangle and the liver bed.