Xanthogranulomatous cholecystitis: a radiological study of 12 cases and a review of the literature |
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Authors: | D Casas R Pérez-Andrés J A Jiménez A Mariscal P Cuadras M Salas M C Gómez-Plaza |
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Institution: | (1) Department of Radiology, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Spain, ES;(2) Department of Surgery, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Spain, ES;(3) Department of Pathology, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Spain, ES |
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Abstract: | Background: Twelve cases of xanthogranulomatous cholecystitis (XGC) are presented, and their radiologic appearance is described.
Methods: Four men and eight women, aged 31–82 years old, with XGC were reviewed. Abdominal ultrasound (US) was performed in all patients.
Computed tomography (CT) was performed in five patients, barium enema examination in two, and percutaneously CT-guided fine-needle
aspirative biopsy of the gallbladder in one.
Results: Barium enema examination showed an indentation of the hepatic flexure. Cholelithiasis was present in all patients, and sludge
was present in six. The gallbladder wall was thickened in all patients, irregular in nine, and could not be properly differentiated
from surrounding liver parenchyma or from other adjacent structures in most patients. A curvilinear halo, hypoechoic on US
and with low attenuation on CT, within the gallbladder wall was found in three patients and pericholecystic fluid in two others.
On CT, the pericholecystic fat had streaky soft tissue densities in three cases. Percutaneously CT-guided fine-needle aspirative
biopsy of the gallbladder was nondiagnostic. The diagnosis of gallbladder carcinoma was considered preoperatively in three
patients.
Conclusion: Despite the characteristic histologic appearance of XCG, radiologic findings are nonspecific, varying from signs observed
in other forms of cholecystitis to the appearance of a gallbladder neoplasm.
Received: 5 April 1995/Accepted: 15 May 1995 |
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Keywords: | : Cholecystitis— Granuloma— Xanthomatosis— Histiocytic— Ultrasonography— Computed tomography |
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