Xanthogranulomatous cholecystitis: a radiological study of 12 cases and a review of the literature.
BACKGROUND
Twelve cases of xanthogranulomatous cholecystitis (XGC) are presented, and their radiologic appearance is described.


METHODS
Four men and eight women, aged 31-82 years old, with XGC were reviewed. Abdominal ultrasound (US) was performed in all patients. Computed tomography (CT) was performed in five patients, barium enema examination in two, and percutaneously CT-guided fine-needle aspirative biopsy of the gallbladder in one.


RESULTS
Barium enema examination showed an indentation of the hepatic flexure. Cholelithiasis was present in all patients, and sludge was present in six. The gallbladder wall was thickened in all patients, irregular in nine, and could not be properly differentiated from surrounding liver parenchyma or from other adjacent structures in most patients. A curvilinear halo, hypoechoic on US and with low attenuation on CT, within the gallbladder wall was found in three patients and pericholecystic fluid in two others. On CT, the pericholecystic fat had streaky soft tissue densities in three cases. Percutaneously CT-guided fine-needle aspirative biopsy of the gallbladder was nondiagnostic. The diagnosis of gallbladder carcinoma was considered preoperatively in three patients.


CONCLUSIONS
Despite the characteristic histologic appearance of XCG, radiologic findings are nonspecific, varying from signs observed in other forms of cholecystitis to the appearance of a gallbladder neoplasm.
Casas
D
D
Department of Radiology, Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Spain.
Pérez-Andrés
R
R
Jiménez
J A
JA
Mariscal
A
A
Cuadras
P
P
Salas
M
M
Gómez-Plaza
M C
MC
D000273:Adipose Tissue / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001466:Barium Sulfate; D001646:Bile; D001707:Biopsy, Needle; D002764:Cholecystitis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002765:Cholecystography; D002769:Cholelithiasis / Q000175:diagnosis; D003287:Contrast Media; D004733:Enema; D005122:Exudates and Transudates; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000175:diagnosis; D006099:Granuloma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014973:Xanthomatosis / Q000175:diagnosis* / Q000000981:diagnostic imaging
D003287:Contrast Media; D001466:Barium Sulfate