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Original Article

J Liaquat Uni Med Health Sci. 2015; 14(3): 115-119


Xanthogranulomatous Cholecystitis (XGC) A Diagnostic Dilemma

Ahmer Akber Memon, Arshad Hussain Abro, Ahmed Hussain Pathan, Faisal Ghani Siddiqui, Abdul Aziz Laghari.

Abstract
INTRODUCTION: Xanthogranulomatous cholecystitis (XGC) is an unusual form of chronic
cholecystitis characterised by marked thickening of the gallbladder wall and accumulation of
lipid laden macrophages. It is frequently misdiagnosed preoperatively with gallbladder
carcinoma. The aim of this study was to assess the preoperative clinical and radiological
characteristics, operative findings and histological features of patients with XGC based on the
experience of a single institution. In addition a literature search was performed to identify
previously reported cases.
PATIENTS AND METHODS: This retrospective study was conducted from January 2009 to December
2014. 1,989 consecutive patients who underwent elective cholecystectomy at the Surgical
Unit-I, Liaquat University Hospital, Jamshoro, Pakistan were included in this study. Seventeen
patients were identified to have XGC on histopathology.
RESULTS: Seventeen (0.8%) cases of XGC were identified in 1,989 cholecystectomy specimens
performed. The female to male ratio was 7.5:1. The average age in our series was 51.6 (range
from 18 to 77 years). Two (11.7%) cases, suspected of malignancy during preoperative work-up,
were reported as XGC on histopathology.
CONCLUSION: Preoperative differentiation between XGC and carcinoma of the gallbladder remains
challenging due to similarities in clinical presentation, radiological and operative findings.
In view of this there should be a low threshold for conversion from a laparoscopic to an
open procedure.

Key words: Xanthogranulomatous, Cholecystitis, Carcinoma



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