Xanthogranulomatous cholecystitis: a rare gallbladder pathology from a single-center perspective

Abstract

Xanthogranulomatous cholecystitis (XGC) was first described as benign and pseudotumor of the gallbladder in 1970 by Christensen and Ishak [1]. It was in 1981 when it was first described as a distinct pathological condition by Goodman and Ishak [2]. Xanthogranulomatosis is an idiopathic, rare process in which lipid-laden histiocytes are deposited at various locations in the body. Xanthogranulomatous inflammation occurs in various organs such as skin, kidney, retroperitoneum, intracranium, gastrointestinal tract, genital organs, and gallbladder [3,4]. XGC is an unusual form of chronic cholecystitis that may simulate malignancy radiologically and pathologically [5]. Many studies have been performed investigating whether there are imaging findings that might permit differentiation of XGC from cancer, such as diffuse gallbladder wall thickening, intramural "nodules" related to macrophage deposition, an intact gallbladder mucosa, and calculi [5,6]. The clinical picture can take the form of acute or chronic cholecystitis and may manifest with different symptoms

Ksantogranülomatöz kolesistitin cerrahi üzerine etkisi

“…However, they reported that 13.8% of the patients had ERCP, 11.1% had choledocholithiasis, 4.6% had cholangitis, and 4.6% had acute pancreatitis in the preoperative period 7 . In our study, pathologies that may lead to extrahepatic bile duct obstruction were observed in patients diagnosed with XGC 4,6 . Although choledocholithiasis were more common in these patients, biliary sludge, Mirizzi syndrome, and double choledochal anomaly were observed in the common bile duct.…”

“…There are few studies in the literature evaluating biliary stasis in the etiopathogenesis of XGC. On the other hand, Saritas et al reported that 31.6% of XGC cases had a pathology that caused biliary stasis 6 . Yücel et al did not emphasize the relationship between conditions causing biliary stasis and XGC in their study.…”

Xanthogranulomatous Cholecystitis: Our Clinical Experience

“…Similarly, the incidence of gall stones was 75%-90% in XGC patients in several studies (3,9). Significant findings that could be useful to differentiate XGC from GBC are disseminated thickening of the gallbladder wall, intramural hypoattenuated nodules accompanied by an undisrupted mucosal line, and the lack of clear liver damage (9). In the present study, abdominal CT and MRI were utilized in 21 and 5 patients, respectively, to obtain detailed information and decide an appropriate surgical method .…”

“…Gallstones were detected in 80.6% of XGC cases in this study. Similarly, the incidence of gall stones was 75%-90% in XGC patients in several studies (3,9). Significant findings that could be useful to differentiate XGC from GBC are disseminated thickening of the gallbladder wall, intramural hypoattenuated nodules accompanied by an undisrupted mucosal line, and the lack of clear liver damage (9).…”

Gallbladder cancer masquerading as xanthogranulomatous cholecystitis: a case report and literature review

“…Tumor markers such as CEA and CA19–9 lack specificity as they can be elevated or within the normal ranges in XGC and GBC patients. Elevated CA19–9 in XGC may be caused by inflammation-induced bile duct damage, resulting in increased secretion of CA19–9 by epithelial cells ( 9 ). Conversely, some GBC patients may have normal tumor marker levels.…”