Xanthogranulomatous cholecystitis: What every radiologist should know

Area of Science:

• Gastroenterology
• Pathology
• Radiology

Background:

• Xanthogranulomatous cholecystitis (XGC) is an uncommon chronic cholecystitis variant.
• Characterized by intramural lipid-laden macrophages and inflammatory cells.
• Severe inflammation can affect adjacent organs, causing adhesions, perforation, abscesses, or fistulas.

Purpose of the Study:

• To review imaging features of XGC.
• To improve understanding and diagnostic yield of XGC.
• To differentiate XGC from gallbladder carcinoma.

Main Methods:

• Review of imaging findings in XGC cases.
• Analysis of characteristic imaging features and associations.
• Comparison with preoperative imaging and intraoperative findings.

Main Results:

• Gallbladder wall thickening and adhesions can mimic gallbladder cancer.
• Intramural hypodense nodules are considered diagnostic.
• Diagnosis can be challenging in atypical cases.

Conclusions:

• Imaging review enhances understanding of XGC.
• Characteristic findings aid in differentiating XGC from gallbladder cancer.
• Fine needle aspiration cytology may be useful in difficult cases; preoperative counseling should include differential diagnoses.