Histopathological study of xanthogranulomatous cholecystitis

A total of 418 gallbladders removed surgically as chronic cholecystitis or carcinoma gallbladder were studied retrospectively for the presence of xanthogranulomas which were found in 45 (10.8%). The age of patients with xanthogranulomatous cholecystitis ranged from 15 to 80 yr with a mean of 45.3 indicating an early presentation of the disease in our population. The male to female ratio was 1:8. The gallbladder was invariably thickened and calculi of cholesterol or mixed type were present in all cases. Xanthogranulomatous foci appeared as yellowish nodules 2-15 mm in size, on the mucosal surface. In some gallbladders, the involvement was diffuse and these foci extended to the surrounding structures. Histologically, xanthogranulomas encompassed the full thickness of the gallbladder wall with variable extension into adjacent fat and connective tissue. This entity deserves distinct clinicopathological recognition, particularly because of a possible confusion with malignancy and the associated complications.