Xanthogranulomatous cholecystitis: case report and review of the literature

We studied a case of xanthogranulomatous cholecystitis, an entity rarely described in English-language literature. Our lesion is unique with regard to the extent of involvement. It is characterized grossly by a markedly thickened gallbladder wall that is yellowish and granular. Microscopically, the gallbladder was diffusely infiltrated by foamy macrophages that contained lipofuscin, lipid material, and bile pigment, features corroborated by transmission electron microscopy. The origin and pathogenesis of xanthogranulomatous cholecystitis was reviewed. We postulate that, in the presence of obstruction and bile stasis, the combination of inflammation, tissue necrosis, and bile extravasation will lead to formation of xanthogranulomas similar to that produced in experimental pyelonephritis.