A Case of Xanthogranulomatous Cholecystitis Differentiated from Gallbllader Carcinoma by Imaging Diagnosis

Toshiaki Shiogama, Takayoshi Tachikawa, Masazumi Terada, Junichirou Furui, Shigetoshi Matsuo, Norihiro Kohara, Toshihumi Eto, Teiji Matsumoto, Tohru Segawa, Koichi Motojima, Tsukasa Tsunoda, Kunihide Izawa*, Kazumori Sakai**

Second Department of Surgery and Emergency Department*, Nagasaki University School of Medicine Sakai Hospital**

Xanthogranulomatous cholecystitis (XGC) is a disease which is difficult to differentiate from gallbladder carcinoma. We report a case of XGC diagnosed preoperatively by imaging diangosis. The patient was a 54-year-old woman, who was referred to our hospital because of suspicion of a gallbladder tumor subsequent to right upper abdominal pain. Abdominal ultrasonography (US) showed a thickened gallbladder wall with a nodular hyperechoic lesion and a giant stone as much as 5 cm in the major axis. Contrast-enhanced computed tomography (CE-CT) revealed a low density area in the gallbladder wall. Angiographic findings revealed expansion and tortuosity of the cystic artery, but no encasement. Cholecystectomy was performed under the diagnosis of XGC. The resected specimen contained yellow nodules, distributed in agreement with the US and CT findings, in the gallbladder wall. Histological examination of the specimen revealed xanthoma cells, lymphocytes, and foreign body giant cells, leading to the diagnosis of XGC.

Key words
xanthogranulomatous cholecystitis, ultrasonography, computed tomography, carcinoma of the gallbladder

Reprint requests
Toshiaki Shiogama Second Department of Surgery, Nagasaki University School of Medicine
7-1 Sakamoto, Nagasaki, 852 JAPAN

Accepted
November 19, 1990

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