腹腔镜下黄色肉芽肿性胆囊炎临床病理分析

目的: 探讨黄色肉芽肿性胆囊炎(XGC)临床病理特点及发病机制,以提高对本病的认识,减少误诊误治. 方法:对543例腹腔镜切除胆囊标本中,经病理确诊的18例XGC结合文献做回顾性分析.结果:18例XGC临床表现缺乏特异性.大体观察胆囊壁不同程度增厚,切面常见淡黄色大小不等的结节或斑块,有的有蒂呈息肉样隆起.镜下见胆囊壁的正常结构受到破坏,代之以特征性黄色肉芽肿性结构,由大量泡沫样细胞、急慢性炎细胞、纤维母细胞、异物巨细胞及Touton细胞等组成.结论: XGC是一种良性而有破坏性的特殊类型胆囊炎,临床诊断困难,确诊有赖于病理诊断.

Xanthogranulomatous Cholecystitis:a Clinicopathological Study of 18 Cases by Peritoneoscope

Objective: To develop the knowledge of XGC and reduce erroneous diagnosis and treatment by exploring pathological feature and mechanism of its onset.Methods:Among Gallbladders resected by peritoneoscope as specimens in 543 cases 18 XGC have been diagnosed through pathology,which are analyzed retrospectively with literature.Results: Clinical presentation of 18 XGC lacks specificity.Varying degrees of thickening in gallbladder wall and straw-colored or brown-yellow plaque or node in cross-section can be seen,some with pedicle swelling like polypus,normal structure of gallbladder wall is found to have bean damadged microscopically,replaced by characteristic yellow granulomatous structure,consisting of plenty of foamy cells,acute and chronic inflammatory cells,fibroblasts,foreign-body giant cells and Touton cells.Conclusion: XGC is a special kind of beneign and destructive cholecystitis,Clinical diagnosis is difficult and depends on pathology.