Xanthogranulomatous cholecystitis complicated with primary sclerosing cholangitis: Report of a case

Abstract

Patients with primary sclerosing cholangitis (PSC) are at an increased risk for biliary tract carcinoma. The preoperative diagnosis of a biliary tract tumor as a malignancy is difficult, even using new modalities such as multidetector computed tomography (MD-CT), magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiography (ERC), and (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET). Surgery is considered to be first line of treatment when these examinations suggest the presence of malignancy in the biliary tract, depending on both the curability of the cancer and the impaired liver function due to PSC. The management of gallbladder masses in patients with PSC remains problematic due to difficulties with the precise diagnosis and adequate surgery. Xanthogranulomatous cholecystitis (XGC) is a type of chronic cholecystitis, and sometimes coexists with gallbladder cancer. It is very difficult to make a preoperative diagnosis differentiating these two diseases. This report presents the case of a patient with XGC, who had been suspected of having gallbladder cancer before surgery, because the tumorous lesion emerged within a year and showed a focally increased uptake by FDG-PET during the follow up for PSC for years. This is the first case of XGC discovered during treatment for PSC.

Xanthogranulomatous cholecystitis in a patient with ulcerative colitis and primary sclerosing cholangitis: A case report

“…There has been a case report of XGC in a patient with PSC by Mori et al. [36] in 2010 and reports of xanthogranulomatous cholangiopathy in patients who underwent transplantation for PSC [37] . However, to the best of our knowledge, our patient is the first case of concomitant UC, PSC, and XGC, along with the presence of intramucosal adenocarcinoma in the distal CBD.…”

Expression of GLUT-1 and GLUT-3 in Xanthogranulomatous Cholecystitis Induced a Positive Result on 18F-FDG PET: Report of a Case

“…It is already known that GLUT-1 together with GLUT-3 is the most important isotype for understanding 18 F-FDG uptake in WBCs. 9 Although several authors have previously reported XGC mimicking gallbladder carcinoma with a false-positive result on 18 F-FDG PET, 27,28 no correlative clinical report has been revealed between 18 F-FDG accumulation and the immunohistochemical expression of GLUTs in the resected XGC specimens. In our case, GLUT-1 and GLUT-3 were both positively expressed in inflammatory cells in the XGC gallbladder wall where 18 F-FDG was accumulated on PET examination.…”

Xanthogranulomatous pancreatitis mimicking a malignant cystic tumor of the pancreas: Report of a case

“…FDG-PET gave false-positive results in all four cases where this test was performed (Table 1). Xanthogranulomatous infl ammation, which contributes to the FDG uptake, 15 has not always been reported to accompany systemic infl ammatory responses (Table 1). Thus, we suggest that FDG-PET may give false-positive results in XGP patients, regardless of whether systemic infl ammatory responses are present.…”