Follicular Cholecystitis Mimicking Xanthogranulomatous Cholecystitis and Malignancy: A Case Report

Abstract

Chronic follicular cholecystitis (CFC) is a rare pathology characterized by prominent lymphoid follicles in the lamina propria distributed throughout the gallbladder wall. It has also been mentioned in the literature as lymphoid hyperplasia and pseudolymphoma. CFC represents less than 2% of cholecystectomies. Its etiopathology is mostly unknown. Most reports are based on histopathological findings, with little or no imaging analysis. We describe a case involving a 66-year-old man radiologically diagnosed as xanthogranulomatous cholecystitis (XGC) versus malignancy, revealing CFC with surrounding inflammatory changes in the cholecystectomy specimen.

Xanthogranulomatous cholecystitis mimicking gallbladder carcinoma: a case report

“…Xanthogranulomatous cholecystitis is a rare variety of chronic cholecystitis 2 , 6 , 8 . XGC is a benign but occasionally aggressive disorder resulting from chronic inflammation of the gallbladder wall 1 .…”

“…Radical cholecystectomy is performed involving en bloc resection of segments IVB and V of the liver when malignancy is suspected 4 . Intraoperative frozen section analysis can be done to differentiate the differential diagnoses 6 , 8 . The postoperative mortality rate and complications are relatively low 4 .…”

Incidental follicular cholecystitis with periductal fibrosis on liver biopsy: Rare findings

“…FC is a rare diagnosis and has not been well described in the literature [4] . Differential diagnoses of FC include primary MALT lymphoma of the gallbladder, xanthogranulomatous cholecystitis, and gallbladder carcinoma [5] , [6] .…”

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“…In GBC patients with p53 overexpression, the 5-year survival rate was 17.2 25 . Ki-67: In a study it was concluded that expression of Ki-67 had a worse postoperative prognosis 26 . Combining various immune markers together for diagnostic purpose led to the highest levels of sensitivity and specificity.…”