Xanthogranulomatous cholecystitis

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 2 February 2018, last major update September 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Xanthogranulomatous cholecystitis gallbladder[TI]

Cite this page: Gulwani, H. Xanthogranulomatous cholecystitis. website. Accessed July 21st, 2018.
Definition / general
  • 1 - 2% of surgically excised gallbladders
  • Usually women ages 60 - 70 years
  • Due to rupture of Rokitansky-Aschoff sinuses with extravasation of bile or ulceration of gallbladder mucosa
  • Resembles carcinoma at surgery; often associated with extended surgical resections (Dig Surg 2012;29:187, Gut Liver 2010;4:518)
  • Frozen sections may prevent extended resections (Cell Biochem Biophys 2012;64:131)
  • Complications include perforation, abscess formation, fistulous tracts, extension to liver, colon or soft tissue
  • Associated with malignancy
Case reports
Gross description
  • Yellow brown, poor to well demarcated foci of wall thickening with variable ulceration, simulates neoplasm
Gross images

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Diffuse wall thickening

Microscopic (histologic) description
  • Foamy macrophages or macrophages with ceroid, bile or iron
  • Also cholesterol clefts and multinucleated giant cells
  • May be focal, nodular or diffuse
  • May contain lymphocytes, plasma cells, foreign body giant cells and neutrophils
Microscopic (histologic) images

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Foamy macrophages and chronic inflammatory cells