Radiologic findings in xanthogranulomatous cholecystitis

Area of Science:

• Radiology
• Pathology

Background:

• Xanthogranulomatous cholecystitis (XGC) is an uncommon inflammatory condition of the gallbladder.
• Limited data exists on the specific radiologic diagnostic criteria for XGC.

Observation:

• Retrospective review of seven histologically confirmed XGC cases.
• Common sonographic findings included gallstones and moderate gallbladder wall thickening.
• CT scans revealed marked gallbladder wall thickening in most cases, with irregular or lobulated features in one.
• Angiography showed cystic artery abnormalities in two cases, raising suspicion for malignancy.

Findings:

• Radiologic findings for XGC are often nonspecific.
• IV cholangiography showed nonopacification or common bile duct stenosis.
• Differential diagnosis between XGC and gallbladder cancer is challenging based on imaging alone.
• Preoperative diagnosis of carcinoma was made in two of the seven cases.

Implications:

• Xanthogranulomatous cholecystitis should be considered a tumor-like condition in radiologic assessments.
• Imaging findings of XGC can overlap with gallbladder carcinoma, impacting preoperative diagnosis.
• Enhanced understanding of XGC imaging characteristics is crucial for accurate differential diagnosis and patient management.