J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 5261KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 91(8): 1001-1010, 1990

Original article

CLINICO-PATHOLOGICAL STUDY OF XANTHOGRANULOMATOUS CHOLECYSTITIS

Department of Gastrointestinal Surgery, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
*) Department of Radiology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
**) Department of Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan

Susumu Kitagawa, Masaaki Nakagawa, Tetsuji Yamada, Yoshihiro Mori, Hiroshi Simizu*), Shhugen Rin**), Hiroshi Kurumaya**)

Xanthogranulomatous cholecystitis(XGC)is an uncommon lesion which may form a tumor-like mass in infiamed gallbladders. In a review of 44 cases there were 40 associated with gallstones which had been incarcerated in the neck of the gallbladder, 10 with past histories of abdominal surgeries, 15 with diabetes mellitus, three with carcinomas in the neck of the gallbladder and four with carcinomas in the other organs.
Radiologically the differential diagnosis of gallbladder cancer and XGC was difificult in several cases. Thiroy five cases of XGC have been diagnosed as chronic cholecystitis and 7 have been mistaken for neoplasms, but recent two have been diagnosed as XGC correctly because we found a characteristic feature of XGC in the contrast enhancement CT that is, detection of an intramural low density mass with continuously enhanced internal membranous layer of the gallbladder wall.
In view of the clinico-pathological findings of XGC, the lesions appear to result from intramural extravasation of bile and subsequent xanthogranulomatous reaction under obstructive conditions in the neck of the gallbladder. We concluded that XGC is not an uncommon special type of cholecystitis but an accompanied lesion sometimes seen in a kind of cholecystitis.

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