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Xanthogranulomatous cholecystitis: A pathologist perspective

Hema Pant.

Background: Xanthogranulomatous cholecystitis (XGC) is an uncommon inflammatory disease of the gallbladder characterized by the infiltration of plasma cells, lipid-laden histiocytes, and the proliferation of fibroblasts in the gallbladder wall. Its importance lies in the fact that imaging studies and intraoperative appearance may be confused with tumors of the gallbladder. It is the name generally used to describe the lesion which results when lipids from the bile in the lumen of the gallbladder enter the wall of the organ and induce a granulomatous inflammation. The present study was undertaken to analyze histological features of XGC along with clinical features and ultrasonographic findings.

Objectives: Correlation of XGC with clinico-radiological findings and to look for various morphological changes microscopically.

Material and Methods: A retrospective study of 1018 patients who had undergone cholecystectomy between July 2014 and June 2016 at our hospital. Totally, 33 cases of XGC were identified among these cholecystectomies. The clinical features and radiological findings of these patients have been analyzed and compared with histologic findings.

Results: The clinical symptoms were abdominal pain, nausea, and jaundice in 81.8%, 60.6%, and 12.12% of the patients. Preoperative ultrasonography for 33 patients revealed gallstone (90.90%) bile sludge (9.09%) and thickened wall in 30.30% of patients.

Conclusions: XGC is difficult to diagnose pre- or intra-operatively and remains a challenge in medical practice. The definitive diagnosis depends on the histopathologic examination.

Key words: Xanthogranulomatous; Cholecystitis; Gallbladder

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American Journal of Research in Medical Sciences


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