Xanthogranulomatous cholecystitis

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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

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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. //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.