Xanthogranulomatous cholecystitis: radiologic findings with histologic correlation that focuses on intramural nodules.
OBJECTIVE
The purpose of this study was to histologically classify intramural nodules associated with xanthogranulomatous cholecystitis and to evaluate the radiologic findings for each type of nodule.


METHODS
Pathologic slides and radiologic studies including 14 sonographic and 16 CT examinations in 19 patients (12 men, seven women; mean age, 61 years) with xanthogranulomatous cholecystitis were reviewed. Radiologic findings were correlated with the histologic type of intramural nodule: abscess, xanthogranuloma, or a combination of the two. The duration of symptoms for each type of intramural nodule was also evaluated.


RESULTS
Histologically, all patients had intramural nodules that were either abscesses (n = 11), xanthogranulomas (n = 5), or a combination of the two (n = 3). Radiologic studies revealed nodules in 10 patients (52.6%; four abscesses, four xanthogranulomas, and two combinations). For abscesses, the mean interval from onset of symptoms to surgery was 25 days; for xanthogranulomas, 70 days (p = .0057). Abscesses were associated with more complications of xanthogranulomatous cholecystitis.


CONCLUSIONS
Intramural nodules in patients with xanthogranulomatous cholecystitis were found to represent abscesses or xanthogranulomas at histology. Xanthogranulomas were more often revealed radiologically than were abscesses. Abscesses caused more clinical complications. Because symptoms lasted longer for xanthogranulomas, we hypothesized that abscesses may become xanthogranulomas.
Kim
P N
PN
Department of Diagnostic Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
Lee
S H
SH
Gong
G Y
GY
Kim
J G
JG
Ha
H K
HK
Lee
Y J
YJ
Lee
M G
MG
Auh
Y H
YH
D000328:Adult; D000368:Aged; D002764:Cholecystitis / Q000000981:diagnostic imaging* / Q000473:pathology; D002765:Cholecystography; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000473:pathology; D006099:Granuloma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014973:Xanthomatosis / Q000000981:diagnostic imaging* / Q000473:pathology