Difference between revisions of "Xanthogranulomatous cholecystitis"

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| ClinDDx    = [[gallbladder carcinoma]], [[acute cholecystitis]]
| ClinDDx    = [[gallbladder carcinoma]], [[acute cholecystitis]]
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'''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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*[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/>


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Revision as of 14:28, 6 January 2016

Xanthogranulomatous cholecystitis
Diagnosis in short

Xanthogranulomatous cholecystitis. H&E stain.
LM cholesterol clefts, granulomas
LM DDx chronic cholecystitis, gallbladder cholesterolosis
Site gallbladder
Clin. DDx gallbladder carcinoma, acute cholecystitis

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

  • XGC - low mag. (WC)

  • XGC - intermed. mag. (WC)

  • XGC - intermed. mag. (WC)

  • XGC - high mag. (WC)

  • XGC - very high mag. (WC)

www:

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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.
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