黄色肉芽肿性胆囊炎CT和病理特征

【目的】探讨黄色肉芽肿性胆囊炎（XGC）的CT和病理特征。【方法】回顾性分析经手术病理证实的13例XGC患者的CT影像学和病理学资料。【结果】13例XGC均表现为胆囊壁不同程度增厚，增强扫描增厚的胆囊壁轻一中度强化，n例增厚的胆囊壁内见条片状、结节状低密度影，增强扫描低密度影均无明显强化；7例囊内壁光整，黏膜线连续；6例黏膜面毛糙，不完整；13例胆囊内见均见结石，4例累及肝脏，5例与周围肠管粘连、分界不清；13例病理特点均表现为胆囊壁特征性的黄色肉芽肿结构，主要为泡沫样组织细胞，大量纤维组织增生，伴有淋巴细胞和浆细胞浸润，6例黏膜糜烂、渍疡形成。【结论】XGC的CT表现及病理具有一定的特征性，CT检查有助于XGC的诊断。

CT and Pathological Features of Xanthogranulomatous Cholecystitis

Objective]To explore the CT and pathological features of xanthogranulomatous cholecystitis （XGC）. Methods] CT images and pathological materials of 13 patients with XGC confirmed by surgical pa- thology were analyzed retrospectively. Results] All the 13 patients with XGC showed thickened gallbladder wall in varying degrees and mild-moderate intensification of thickened gallbladder wall in contrast enhance- ment. The thickened gallbladder wall of 11 patients showed strip-lamellar and nodular low density shadow. No obvious intensification was seen in the contrast enhancement of low density shadow. Of the 13 patients, 7 pa- tients showed even cystic inner wall and consecutive mucosal lines, and 6 patients showed rough and uncom pleted mucous. Gallbladder calculi were found in all of the 13 patients, of which 4 patients involved in the liv- er, and 5 patients were adhesive to the adjacent intestines with blurred boundaries. Pathological features of 13 patients showed xanthogranuloma structure with characteristic gallbladder wall, which mainly were foamy his- tocytes, proliferation of many fibrous tissues and infiltration of lymphocytes and plasma cells. Mucosal erosion and ulcer were found in 6 patients. Conclusion]CT manifestation and pathology of XGC have certain charac- teristics. CT examination is helpful for the diagnosis of XGC.