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2016 ; 8
(2
): 183-91
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Xanthogranulomatous cholecystitis: What every radiologist should know
#MMPMID26981227
Singh VP
; Rajesh S
; Bihari C
; Desai SN
; Pargewar SS
; Arora A
World J Radiol
2016[Feb]; 8
(2
): 183-91
PMID26981227
show ga
Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic
cholecystitis characterized by xanthogranulomatous inflammation of the
gallbladder. Intramural accumulation of lipid-laden macrophages and acute and
chronic inflammatory cells is the hallmark of the disease. The
xanthogranulomatous inflammation of the gallbladder can be very severe and can
spill over to the neighbouring structures like liver, bowel and stomach resulting
in dense adhesions, perforation, abscess formation, fistulous communication with
adjacent bowel. Striking gallbladder wall thickening and dense local adhesions
can be easily mistaken for carcinoma of the gallbladder, both intraoperatively as
well as on preoperative imaging. Besides, cases of concomitant gallbladder
carcinoma complicating XGC have also been reported in literature. So, we have
done a review of the imaging features of XGC in order to better understand the
entity as well as to increase the diagnostic yield of the disease summarizing the
characteristic imaging findings and associations of XGC. Among other findings,
presence of intramural hypodense nodules is considered diagnostic of this entity.
However, in some cases, an imaging diagnosis of XGC is virtually impossible. Fine
needle aspiration cytology might be handy in such patients. A preoperative
counselling should include possibility of differential diagnosis of gallbladder
cancer in not so characteristic cases.