Xanthogranulomatous cholecystitis

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

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

General

Gross

Features:[5]

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

Imaging:

  • Hypo-attenuated nodules in the gallbladder wall.[5]

Microscopic

Features:[3]

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

DDx:

Images

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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.

See also

References

  1. 1.0 1.1 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.
  2. 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.
  3. 3.0 3.1 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/.
  4. 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.
  5. 5.0 5.1 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.
  6. 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.