Difference between revisions of "Xanthogranulomatous cholecystitis"

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'''Xanthogranulomatous cholecystitis''', abbreviated '''XGC''', is an uncommon pathology of the [[gallbladder]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Xanthogranulomatous cholecystitis -- low mag.jpg
| Width      =
| Caption    = Xanthogranulomatous cholecystitis. [[H&E stain]].
| Micro      = cholesterol clefts, [[granulomas]]
| Subtypes  =
| LMDDx      = [[chronic cholecystitis]], [[gallbladder cholesterolosis]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = thickened gallbladder wall, [[gallstones]]
| Grossing  =
| Site      = [[gallbladder]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = uncommon
| Bloodwork  =
| Rads      = hypo-attenuated nodules in gallbladder wall
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = [[gallbladder carcinoma]], [[acute cholecystitis]]
| Tx        = cholecystectomy (surgical removal)
}}
'''Xanthogranulomatous cholecystitis''', abbreviated '''XGC''',<ref name=pmid25404941>{{Cite journal  | last1 = Rammohan | first1 = A. | last2 = Cherukuri | first2 = SD. | last3 = Sathyanesan | first3 = J. | last4 = Palaniappan | first4 = R. | last5 = Govindan | first5 = M. | title = Xanthogranulomatous cholecystitis masquerading as gallbladder cancer: can it be diagnosed preoperatively? | journal = Gastroenterol Res Pract | volume = 2014 | issue =  | pages = 253645 | month =  | year = 2014 | doi = 10.1155/2014/253645 | PMID = 25404941 }}</ref> is an uncommon pathology of the [[gallbladder]].


==General==
==General==
*Uncommon ~ 1-9%.<ref name=pmid23991684>{{Cite journal  | last1 = Hale | first1 = MD. | last2 = Roberts | first2 = KJ. | last3 = Hodson | first3 = J. | last4 = Scott | first4 = N. | last5 = Sheridan | first5 = M. | last6 = Toogood | first6 = GJ. | title = Xanthogranulomatous cholecystitis: a European and global perspective. | journal = HPB (Oxford) | volume =  | issue =  | pages =  | month = Aug | year = 2013 | doi = 10.1111/hpb.12152 | PMID = 23991684 }}</ref><ref name=pmid24019688>{{Cite journal  | last1 = Alvi | first1 = AR. | last2 = Jalbani | first2 = I. | last3 = Murtaza | first3 = G. | last4 = Hameed | first4 = A. | title = Outcomes of Xanthogranulomatous cholecystitis in laparoscopic era: A retrospective Cohort study. | journal = J Minim Access Surg | volume = 9 | issue = 3 | pages = 109-15 | month = Jul | year = 2013 | doi = 10.4103/0972-9941.115368 | PMID = 24019688 }}</ref>
*Uncommon ~ 1-9%.<ref name=pmid23991684>{{Cite journal  | last1 = Hale | first1 = MD. | last2 = Roberts | first2 = KJ. | last3 = Hodson | first3 = J. | last4 = Scott | first4 = N. | last5 = Sheridan | first5 = M. | last6 = Toogood | first6 = GJ. | title = Xanthogranulomatous cholecystitis: a European and global perspective. | journal = HPB (Oxford) | volume =  | issue =  | pages =  | month = Aug | year = 2013 | doi = 10.1111/hpb.12152 | PMID = 23991684 }}</ref><ref name=pmid24019688>{{Cite journal  | last1 = Alvi | first1 = AR. | last2 = Jalbani | first2 = I. | last3 = Murtaza | first3 = G. | last4 = Hameed | first4 = A. | title = Outcomes of Xanthogranulomatous cholecystitis in laparoscopic era: A retrospective Cohort study. | journal = J Minim Access Surg | volume = 9 | issue = 3 | pages = 109-15 | month = Jul | year = 2013 | doi = 10.4103/0972-9941.115368 | PMID = 24019688 }}</ref>
*May be confused (clinically) with [[gallbladder carcinoma]].<ref name=pmid23991684/><ref name=pmid23060404>{{Cite journal  | last1 = Martins | first1 = PN. | last2 = Sheiner | first2 = P. | last3 = Facciuto | first3 = M. | title = Xanthogranulomatous cholecystitis mimicking gallbladder cancer and causing obstructive cholestasis. | journal = Hepatobiliary Pancreat Dis Int | volume = 11 | issue = 5 | pages = 549-52 | month = Oct | year = 2012 | doi =  | PMID = 23060404 }}</ref>  
**Approximately 2% in one series of 724 gallbladders.<ref name=pmid3584484>{{Cite journal  | last1 = Roberts | first1 = KM. | last2 = Parsons | first2 = MA. | title = Xanthogranulomatous cholecystitis: clinicopathological study of 13 cases. | journal = J Clin Pathol | volume = 40 | issue = 4 | pages = 412-7 | month = Apr | year = 1987 | doi =  | PMID = 3584484 | PMC = 1140974 }}</ref>
*May be confused (clinically) with [[gallbladder carcinoma]].<ref name=pmid25404941/><ref name=pmid23991684/><ref name=pmid23060404>{{Cite journal  | last1 = Martins | first1 = PN. | last2 = Sheiner | first2 = P. | last3 = Facciuto | first3 = M. | title = Xanthogranulomatous cholecystitis mimicking gallbladder cancer and causing obstructive cholestasis. | journal = Hepatobiliary Pancreat Dis Int | volume = 11 | issue = 5 | pages = 549-52 | month = Oct | year = 2012 | doi =  | PMID = 23060404 }}</ref>  


==Gross==
==Gross==
Line 15: Line 46:


==Microscopic==
==Microscopic==
Features:
Features:<ref name=pmid3584484>{{Cite journal  | last1 = Roberts | first1 = KM. | last2 = Parsons | first2 = MA. | title = Xanthogranulomatous cholecystitis: clinicopathological study of 13 cases. | journal = J Clin Pathol | volume = 40 | issue = 4 | pages = 412-7 | month = Apr | year = 1987 | doi =  | PMID = 3584484 | PMC = 1140974 }}</ref>
*Cholesterol clefts.
*[[Granulomas]].
*[[Granulomas]].
*Lipid-laden macrophages.
*+/-Cholesterol clefts.
*Inflammatory cells.
*Fibrosis.
DDx:
*[[Chronic cholecystitis]].
*[[Gallbladder cholesterolosis]].
===Images===
<gallery>
Image: Xanthogranulomatous cholecystitis -- low mag.jpg | XGC - low mag. (WC)
Image: Xanthogranulomatous cholecystitis -- intermed mag.jpg | XGC - intermed. mag. (WC)
Image: Xanthogranulomatous cholecystitis - alt -- intermed mag.jpg | XGC - intermed. mag. (WC)
Image: Xanthogranulomatous cholecystitis -- high mag.jpg | XGC - high mag. (WC)
Image: Xanthogranulomatous cholecystitis -- very high mag.jpg | XGC - very high mag. (WC)
</gallery>
www:
*[http://www.radiologycases.com/index.php/radiologycases/article/view/696 XGC (radiologycases.com)].<ref>{{Cite journal  | last1 = Cecava | first1 = ND. | last2 = Andrews | first2 = R. | title = Case report of xanthogranulomatous cholecystitis, review of its sonographic and magnetic resonance findings, and distinction from other gallbladder pathology. | journal = J Radiol Case Rep | volume = 5 | issue = 4 | pages = 19-24 | month =  | year = 2011 | doi = 10.3941/jrcr.v5i4.696 | PMID = 22470787 }}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4227324/figure/fig3/ XGC (nih.gov)].<ref name=pmid25404941/>
==Sign out==
<pre>
Gallbladder, Cholecystectomy:
- Xanthogranulomatous cholecystitis.
- Cholelithiasis.
</pre>
===Block letters===
<pre>
GALLBLADDER, CHOLECYSTECTOMY:
- XANTHOGRANULOMATOUS CHOLECYSTITIS.
- CHOLELITHIASIS.
</pre>
===Micro===
The sections show a thickened gallbladder wall with cholesterol clefts, multinucleated
giant cells, fibrosis and lymphoid aggregates.  No metaplasia, nuclear atypia or dysplasia
is apparent.
====Alternate====
The sections show a thickened gallbladder wall with cholesterol clefts, multinucleated
giant cells, fibrosis and small lymphoid aggregates. No metaplasia, dysplasia or
significant nuclear atypia is apparent.


==See also==
==See also==
49,259

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