Xanthogranulomatous cholecystitis

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, is an uncommon pathology of the gallbladder.

General

• Uncommon ~ 1-9%.
  • Approximately 2% in one series of 724 gallbladders.
• May be confused (clinically) with gallbladder carcinoma.

Gross

Features:

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

Imaging:

• Hypo-attenuated nodules in the gallbladder wall.

Microscopic

Features:

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

DDx:

• Chronic cholecystitis.
• Gallbladder cholesterolosis.

Images

• 

  XGC - low mag. (WC)

• 

  XGC - intermed. mag. (WC)

• 

  XGC - intermed. mag. (WC)

• 

  XGC - high mag. (WC)

• 

  XGC - very high mag. (WC)

www:

• XGC (radiologycases.com).

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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

• Gallbladder.
• Chronic cholecystitis.
• Acute cholecystitis.