Xanthogranulomatous Cholecystitis : A Diagnostic Challenge for Radiologists, Surgeons, and Pathologists

Copyright © 2020, Rahman et al..

Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder characterized by severe proliferative fibrosis and the accumulation of lipid-laden macrophages in areas of destructive inflammation. Misdiagnosis is highly usual, and its macroscopic appearance may often be confused with gallbladder carcinoma. Here we discuss the case of a 56-year-old male who presented in the emergency room with fever, chills, and nausea. The routine laboratory investigations were normal except for elevated white blood cell counts. Abdominal ultrasound showed borderline gallbladder wall thickening. However, after CT scan findings, the suspect diagnosis of acute cholecystitis with possible perforation was made and the cholecystectomy was performed. The definitive diagnosis was delayed until the final pathology result came as a surprise, and later confirmed the histologic diagnosis of XGC. We consider this an important case because of the histopathologic finding of fibrotic thickened gallbladder wall with abundant histiocytes and pericholecystic fat stranding along with perforation and extensive inflammatory changes in the right upper quadrant of the abdomen which is highly suggestive and indicative of XGC in comparison to gallbladder carcinoma (GC). All things considered, clinically and grossly XGC presents in a similar fashion as GC; histopathology confirmed the diagnosis of XGC.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:12

Enthalten in:

Cureus - 12(2020), 8 vom: 25. Aug., Seite e10007

Sprache:

Englisch

Beteiligte Personen:

Rahman, Jawaria [VerfasserIn]
Tahir, Muhammad [VerfasserIn]
Sonawane, Snehal [VerfasserIn]

Links:

Volltext

Themen:

Acute cholecystitis
Case Reports
Gall bladder carcinoma
Gall bladder histopathology
Gallstone cholecystitis
Xanthogranulomatous cholecystitis

Anmerkungen:

Date Revised 01.10.2020

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.7759/cureus.10007

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM315544244