Difference between revisions of "Xanthogranulomatous cholecystitis"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      =  
| Image      = Xanthogranulomatous cholecystitis -- low mag.jpg
| Width      =
| Width      =
| Caption    =  
| Caption    = Xanthogranulomatous cholecystitis. [[H&E stain]].
| Micro      = cholesterol clefts, [[granulomas]]
| Micro      = cholesterol clefts, [[granulomas]]
| Subtypes  =
| Subtypes  =
Line 12: Line 12:
| Molecular  =
| Molecular  =
| IF        =
| IF        =
| Gross      =
| Gross      = thickened gallbladder wall, [[gallstones]]
| Grossing  =
| Grossing  =
| Site      = [[gallbladder]]
| Site      = [[gallbladder]]
Line 20: Line 20:
| Signs      =
| Signs      =
| Symptoms  =
| Symptoms  =
| Prevalence =
| Prevalence = uncommon
| Bloodwork  =
| Bloodwork  =
| Rads      =
| Rads      = hypo-attenuated nodules in gallbladder wall
| Endoscopy  =
| Endoscopy  =
| Prognosis  =
| Prognosis  = benign
| Other      =
| Other      =
| ClinDDx    = [[gallbladder carcinoma]], [[acute cholecystitis]]
| ClinDDx    = [[gallbladder carcinoma]], [[acute cholecystitis]]
| Tx        = cholecystectomy (surgical removal)
}}
}}
'''Xanthogranulomatous cholecystitis''', abbreviated '''XGC''', is an uncommon pathology of the [[gallbladder]].
'''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>
**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>
**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=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>  
*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==
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*[[Gallbladder cholesterolosis]].
*[[Gallbladder cholesterolosis]].


Image:
===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.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==
==Sign out==
<pre>
Gallbladder, Cholecystectomy:
- Xanthogranulomatous cholecystitis.
- Cholelithiasis.
</pre>
===Block letters===
<pre>
<pre>
GALLBLADDER, CHOLECYSTECTOMY:
GALLBLADDER, CHOLECYSTECTOMY:
Line 70: Line 87:
giant cells, fibrosis and lymphoid aggregates.  No metaplasia, nuclear atypia or dysplasia
giant cells, fibrosis and lymphoid aggregates.  No metaplasia, nuclear atypia or dysplasia
is apparent.
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==

Latest revision as of 03:54, 31 May 2016

Xanthogranulomatous cholecystitis
Diagnosis in short

Xanthogranulomatous cholecystitis. H&E stain.

LM cholesterol clefts, granulomas
LM DDx chronic cholecystitis, gallbladder cholesterolosis
Gross thickened gallbladder wall, gallstones
Site gallbladder

Prevalence uncommon
Radiology hypo-attenuated nodules in gallbladder wall
Prognosis benign
Clin. DDx gallbladder carcinoma, acute cholecystitis
Treatment cholecystectomy (surgical removal)

Xanthogranulomatous cholecystitis, abbreviated XGC,[1] is an uncommon pathology of the gallbladder.

General

Gross

Features:[6]

  • Wall thickening ~ 90% of cases.
  • Gallstones ~ 70% of cases.
  • +/-Infiltration of surrounding tissues (liver, fat).

Imaging:

  • Hypo-attenuated nodules in the gallbladder wall.[6]

Microscopic

Features:[4]

  • Granulomas.
  • Lipid-laden macrophages.
  • +/-Cholesterol clefts.
  • Inflammatory cells.
  • Fibrosis.

DDx:

Images

www:

Sign out

Gallbladder, Cholecystectomy:
- Xanthogranulomatous cholecystitis.
- Cholelithiasis.

Block letters

GALLBLADDER, CHOLECYSTECTOMY:
- XANTHOGRANULOMATOUS CHOLECYSTITIS.
- CHOLELITHIASIS.

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

References

  1. 1.0 1.1 1.2 Rammohan, A.; Cherukuri, SD.; Sathyanesan, J.; Palaniappan, R.; Govindan, M. (2014). "Xanthogranulomatous cholecystitis masquerading as gallbladder cancer: can it be diagnosed preoperatively?". Gastroenterol Res Pract 2014: 253645. doi:10.1155/2014/253645. PMID 25404941.
  2. 2.0 2.1 Hale, MD.; Roberts, KJ.; Hodson, J.; Scott, N.; Sheridan, M.; Toogood, GJ. (Aug 2013). "Xanthogranulomatous cholecystitis: a European and global perspective.". HPB (Oxford). doi:10.1111/hpb.12152. PMID 23991684.
  3. Alvi, AR.; Jalbani, I.; Murtaza, G.; Hameed, A. (Jul 2013). "Outcomes of Xanthogranulomatous cholecystitis in laparoscopic era: A retrospective Cohort study.". J Minim Access Surg 9 (3): 109-15. doi:10.4103/0972-9941.115368. PMID 24019688.
  4. 4.0 4.1 Roberts, KM.; Parsons, MA. (Apr 1987). "Xanthogranulomatous cholecystitis: clinicopathological study of 13 cases.". J Clin Pathol 40 (4): 412-7. PMC 1140974. PMID 3584484. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1140974/.
  5. Martins, PN.; Sheiner, P.; Facciuto, M. (Oct 2012). "Xanthogranulomatous cholecystitis mimicking gallbladder cancer and causing obstructive cholestasis.". Hepatobiliary Pancreat Dis Int 11 (5): 549-52. PMID 23060404.
  6. 6.0 6.1 Zhao, F.; Lu, PX.; Yan, SX.; Wang, GF.; Yuan, J.; Zhang, SZ.; Wang, YX. (Sep 2013). "CT and MR features of xanthogranulomatous cholecystitis: an analysis of consecutive 49 cases.". Eur J Radiol 82 (9): 1391-7. doi:10.1016/j.ejrad.2013.04.026. PMID 23726123.
  7. Cecava, ND.; Andrews, R. (2011). "Case report of xanthogranulomatous cholecystitis, review of its sonographic and magnetic resonance findings, and distinction from other gallbladder pathology.". J Radiol Case Rep 5 (4): 19-24. doi:10.3941/jrcr.v5i4.696. PMID 22470787.