A case report of Xanthogranulomatous Cholecystitis
AJTES Vol 5, No 1, January 2021
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Xanthogranulomatous cholecystitis, gallbladder MRI, GB carcinoma, Chronic cholecystitis.

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Abdelmoneim, A., Darweesh, A., Kounsal, A., & Abougazia, A. (2021). A case report of Xanthogranulomatous Cholecystitis. Albanian Journal of Trauma and Emergency Surgery, 5(1), 813-818. https://doi.org/10.32391/ajtes.v5i1.166



Xanthogranulomatous cholecystitis is a benign, uncommon type of chronic cholecystitis manifested by focal or diffuse severe inflammatory process of the gallbladder (GB).  It is inflammatory disease of the gallbladder characterized by the infiltrations of plasma cells, lipid-laden histiocytes, and the fibroblasts proliferation in GB wall. Gallstones are present in all patients, and like most symptomatic gallbladder diseases, there is a female predominance. It is an active inflammatory process which could leads to significant morbidity. The term Xanthogranulomatous cholecystitis was initially proposed by Goodman and Ishak in 1981. The pathogenesis of XGC is the rupture of Rokitansky-Aschoff sinuses and extravasation of bile into the muscular layer. The rupture of the serosa results in adhesion to the adjacent liver, duodenum, and transverse colon.  Macroscopically, it appears like yellowish masses in the wall of the GB. Radiologically it is an important mimic of gallbladder carcinoma.

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Rammohan A, Cherukuri SD, Sathyanesan J, Palaniappan R, Govindan M. Xanthogranulomatous cholecystitis masquerading as gallbladder cancer: can it be diagnosed preoperatively? Gastroenterol Res Pract. 2014; 2014: 253645.

Christensen AH, Ishak KG. Benign tumors and pseudotumors of the gallbladder: report of 180 cases. Arch Pathol 1970; 90: 423–432.

Takahashi K, Oka K, Hakozaki H, Kojima M. Ceroidlike histiocytic granulomas of gallbladder. A previously undescribed lesion. Acta Pathol Jpn 1976; 26: 25–46.

Mehrotra ML, Bhatnagai BNS. Biliary granulomatous cholecystitis. J Indian Med Assoc 1982; 79: 144–145.

McCoy JJ, Vila R, Petrossian G, McCall RA, Reddy KS. Xanthogranulomatous cholecystitis: report of two cases. J S C Med Assoc 1976; 72: 78–79.

McCoy JJ, Vila R, Petrossian G, McCall RA, Reddy KS. Xanthogranulomatous cholecystitis. Report of two cases. J S C Med Assoc. 1976; 72: 78–79.

Christensen AH, Ishak KG. Benign tumors and pseudotumors of the gallbladder. Report of 180 cases. Arch Pathol. 1970; 90: 423–432.

Amazon K, Rywlin AM. Ceroid granulomas of the gallbladder. Am J ClinPathol. 1980; 73: 123–127.

Goodman ZD, Ishak KG. Xanthogranulomatous cholecystitis. Am J Surg Pathol 1981; 5: 653–659.

Reyes CV, Jablokow VR, Reid R. Xanthogranulomatous cholecystitis: report of seven cases. Am Surg 1981; 47: 322–325.

Franco V, Aragona F, Genova G, Florena AM, Stella M, Campesi G. Xanthogranulomatous cholecystitis: histopathological study and classification. Pathol Res Pract 1990; 186: 390.

Fligial S, Lewin KJ. Xanthogranulomatous cholecystitis. Arch Pathoi Lab Med 1982; 106: 302–304.

Guzmán-Valdivia G. Xanthogranulomatous cholecystitis in laparoscopic surgery. J Gastrointest Surg. 2005; 9: 494–497.

Roberts KM, Parsons MA. Xanthogranulomatous cholecystitis: clinicopathological study of 13 cases. J Clin Pathol. 1987; 40: 412–417.

Houston JP, Collins MC, Cameron I, Reed MW, Parsons MA, Roberts KM. Xanthogranulomatous cholecystitis. Br J Surg. 1994; 81: 1030–1032.

Yu H, Yu TN, Cai XJ. Tumor biomarkers: help or mislead in the diagnosis of xanthogranulomatous cholecystitis? - analysis of serum CA 19-9, carcinoembryonic antigen, and CA 12-5. Chin Med J (Engl) 2013;126: 3044–3047.

Krishnani N, Shukla S, Jain M, Pandey R, Gupta RK. Fine needle aspiration cytology in xanthogranulomatous cholecystitis, gallbladder adenocarcinoma and coexistent lesions. Acta Cytol. 2000; 44: 508–514.

Benbow EW. Xanthogranulomatous cholecystitis associated with carcinoma of the gallbladder. Postgrad Med J. 1989; 65:528–531.

Kim PN, Lee SH, Gong GY, Kim JG, Ha HK, Lee YJ, Lee MG, Auh YH. Xanthogranulomatous cholecystitis: radiologic findings with histologic correlation that focuses on intramural nodules. AJR Am J Roentgenol. 1999;172: 949–953.

Benbow EW, Taylor PM. Simultaneous xanthogranulomatous cholecystitis and primary adenocarcinoma of gallbladder. Histopathology. 1988; 12: 672–675.

Howard TJ, Bennion RS, Thompson JE. Xanthogranulomatous cholecystitis: a chronic inflammatory pseudotumor of the gallbladder. Am Surg. 1991; 57:821–824.

Parra JA, Acinas O, Bueno J, Güezmes A, Fernández MA, Fariñas MC. Xanthogranulomatous cholecystitis: clinical, sonographic, and CT findings in 26 patients. AJR Am J Roentgenol. 2000; 174: 979–983.

Kim PN, Ha HK, Kim YH, Lee MG, Kim MH, Auh YH. US findings of xanthogranulomatous cholecystitis. Clin Radiol. 1998; 53: 290–292.

Casas D, Pérez-Andrés R, Jiménez JA, Mariscal A, Cuadras P, Salas M, Gómez-Plaza MC. Xanthogranulomatous cholecystitis: a radiological study of 12 cases and a review of the literature. Abdom Imaging. 1996; 21: 456–460.

Zhao F, Lu PX, Yan SX, Wang GF, Yuan J, Zhang SZ, Wang YX. CT and MR features of xanthogranulomatous cholecystitis: an analysis of consecutive 49 cases. Eur J Radiol. 2013; 82: 1391–1397.

Goshima S, Chang S, Wang JH, Kanematsu M, Bae KT, Federle MP. Xanthogranulomatous cholecystitis: diagnostic performance of CT to differentiate from gallbladder cancer. Eur J Radiol. 2010; 74: e79–e83.

Chun KA, Ha HK, Yu ES, Shinn KS, Kim KW, Lee DH, Kang SW, Auh YH. Xanthogranulomatous cholecystitis: CT features with emphasis on differentiation from gallbladder carcinoma. Radiology. 1997; 203: 93–97.

Shuto R, Kiyosue H, Komatsu E, Matsumoto S, Kawano K, Kondo Y, Yokoyama S, Mori H. CT and MR imaging findings of xanthogranulomatous cholecystitis: correlation with pathologic findings. Eur Radiol. 2004;14: 440–446.

Goldar-Najafi A, Khettry U. Xanthogranulomatous choledochitis: a previously undescribed mass lesion of the hepatobiliary and ampullary region. Semin Liver Dis. 2003; 23: 101–106.

Binit Sureka, Vaibhav Pratap Singh, Rajesh Rajesh, Shalini Laroia, Kalpana Bansal, Archana Rastogi, Chhagan Bihari, Ajeet Singh Bhadoria, Nikhil Agrawal, Asit Arora. Computed Tomography (CT) and Magnetic Resonance (MR) Findings in Xanthogranulomatous Cholecystitis: Retrospective Analysis of Pathologically Proven 30 Cases – Tertiary Care Experience. Pol J Radiol, 2017; 82: 327-332

Kang TW, Kim SH, Park HJ, Lim S, Jang KM, Choi D, Lee SJ. Differentiating xanthogranulomatous cholecystitis from a wall-thickening type of gallbladder cancer: added value of diffusion-weighted MRI. Clin Radiol. 2013; 68: 992–1001.

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