Xanthogranulomatous cholecystitis: a radiological study of 12 cases and a review of the literature

Casas, D.; Pérez-Andrés, Ricard; Jiménez, J.; Mariscal, Antonio Joaquín Franco; Cuadras, Patricia; Salas, María Murillo; Gómez-Plaza, M C

doi:10.1007/s002619900104

Cited by 58 publications

(39 citation statements)

References 18 publications

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“…A preoperative diagnosis of XGC is difficult, and intraoperative diagnosis from a frozen section is often needed to differentiate XGC from carcinoma. 9,11 USG results revealing the existence of hypoechoic nodules or bands in the wall of the gallbladder or CT findings showing a hypodense band around the gallbladder may be strong indications of XGC 7 ; however, there were only 2 patients in the present series with such CT findings. Cholecystectomy (complete or partial) is the treatment of choice for XGC.…”

Section: Discussioncontrasting

confidence: 47%

A Rare Finding During a Common Procedure: Xanthogranulomatous Cholecystitis

Taskesen

Arıkanoğlu

Uslukaya

et al. 2014

International Surgery

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Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in regions of destructive inflammation. Xanthogranulomatous cholecystitis clinically and radiologically mimics early-stage gallbladder cancer, with wall thickening on computed tomography. The study included 14 xanthogranulomatous cholecystitis patients that were identified following retrospective analysis of the records of 1248 patients that underwent cholecystectomy between 2005 and 2011. Mean age of the 5 male and 9 female patients was 56.7 years. All 14 patients had gallbladder stones; 10 had a history of acute cholecystitis, 1 had cholangitis, and 2 presented with obstructive jaundice. A right-upper quadrant mass was palpable in 2 patients. All patients underwent cholecystectomy. Open surgery was planned and performed in 6 of the 14 patients, and laparoscopic cholecystectomy was planned in 8 patients, but was converted to open surgery in 1 case. In total, 1 patient developed wound infection, 1 patient had postoperative pneumonia, and 1 patient developed intraabdominal hematoma. None of the patients in the series died. Xanthogranulomatous cholecystitis is difficult to diagnose, both preoperatively and intraoperatively, and definitive diagnosis depends exclusively on pathological examination. Xanthogranulomatous cholecystitis should be a consideration in all difficult cholecystectomy cases.

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Section: Discussioncontrasting

confidence: 47%

A Rare Finding During a Common Procedure: Xanthogranulomatous Cholecystitis

Taskesen

Arıkanoğlu

Uslukaya

et al. 2014

International Surgery

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“…Such lesions are indistinguishable from gallbladder cancer which has invaded into organs such as the liver, duodenum and transverse colon both clinically 9 and radiologically. [10][11][12] The use of percutaneous fine-needle aspiration (PFNA) in differentiating xanthogranulomatous cholecystitis from carcinoma of the gallbladder is still controversial. PFNA has been reported to be useful in diagnosing xanthogranulomatous cholecystitis by the characteristic cytological features.…”

Section: Discussionmentioning

confidence: 99%

Xanthogranulomatous cholecystitis: A rare condition with variable presentations

Tsang

Cheung

et al. 2009

Surgical Practice

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Aim: Patients suffering from xanthogranulomatous cholecystitis have variable clinical presentations. The present study aims to evaluate the clinical presentations of the disease and the various surgical treatment strategies in the management of patients suffering from xanthogranulomatous cholecystitis. Methods: This is a retrospective study in a university teaching hospital and a tertiary referral centre. The histopathological records of 5016 resected gallbladder specimens from January 1991 to June 2007 were reviewed and case notes of patients with a diagnosis of xanthogranulomatous cholecystitis were retrieved. Results: Eighty‐six patients with xanthogranulomatous cholecystitis were identified. The spectrum of presentation was variable and a high proportion of patients had complicated pathology. Patients commonly presented with obstructive jaundice or acute cholecystitis. The proportion of patients with diabetes mellitus who presented with acute cholecystitis was higher than the local prevalence in this study. Conversion rate in laparoscopic cholecystectomy was also higher for patients with xanthogranulomatous cholecystitis. Conclusion: The clinical presentation of xanthogranulomatous cholecystitis is variable. The disease commonly presents as obstructive jaundice or acute cholecystitis but it may mimic carcinoma of the gallbladder. The disease carries a higher rate of conversion if laparoscopic cholecystectomy was attempted.

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“…The preoperative diagnosis of XGC is difficult, and an intraoperative diagnosis from frozen sections is often needed to distinguish it from carcinoma [4,7,12,17]. According to Parra et al [18], the presence of hypoechoic nodules or bands in the gallbladder wall on US or of a hypodense band around the gallbladder on CT, is highly suggestive of this disease.…”

Section: Discussionmentioning

confidence: 99%