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Endoscopic sonography in the diagnosis of xanthogranulomatous cholecystitis
N Muguruma1, S Okamura, T Okahisa
1The Second Department of Internal Medicine, School of Medicine, The University of Tokushima, Japan.
Insights
Xanthogranulomatous cholecystitis (XGC) is a rare gallbladder inflammation mimicking cancer. Imaging like EUS shows nodules but cannot definitively distinguish XGC from gallbladder cancer due to wall changes and infiltration.
Area of Science:
- Gastroenterology
- Radiology
- Pathology
Background:
- Xanthogranulomatous cholecystitis (XGC) is a rare, severe gallbladder inflammation.
- It can mimic gallbladder cancer clinically and radiologically.
Observation:
- This study reports on 3 cases of XGC evaluated with conventional sonography, endoscopic sonography (EUS), and CT.
- EUS revealed hyperechoic nodules within the gallbladder wall, suggestive of xanthogranulomas.
Findings:
- Differentiating XGC from gallbladder cancer proved challenging.
- Loss of the normal multilayered gallbladder wall structure and infiltration into adjacent organs on EUS contributed to diagnostic difficulty.
Implications:
- Accurate differentiation of XGC from gallbladder cancer is crucial for appropriate patient management.
- Multimodality imaging may be required, and histopathological confirmation is often necessary.
Abstract:
Xanthogranulomatous cholecystitis (XGC) is an unusual inflammatory disease of the gallbladder that may simulate gallbladder cancer. We report the findings with conventional sonography, endoscopic sonography (EUS), and CT in 3 cases of XGC. EUS could visualize hyperechoic nodules in the gallbladder wall, probably representing xanthogranulomas, but loss of the multilayered structure of the gallbladder wall and infiltration into adjacent organs make differentiating XGC from gallbladder cancer difficult with EUS alone.