Gallbladder & extrahepatic bile ducts
Cholecystitis
Xanthogranulomatous cholecystitis
Author: Hanni Gulwani, M.B.B.S.
Topic Completed: 1 September 2012
Minor changes: 5 September 2019
Copyright: 2003-2019, PathologyOutlines.com, Inc.
PubMed Search: Xanthogranulomatous cholecystitis gallbladder[TI]
Table of Contents
Definition / general | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Differential diagnosisCite this page: Gulwani H. Xanthogranulomatous cholecystitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/gallbladderxanthogranulomatous.html. Accessed August 7th, 2020.
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
- 76 year old man with false positive PET scan (World J Gastroenterol 2009;15:3691)
- 80 year old woman with perforation presenting as biloma (Korean J Gastroenterol 2011;58:153)
- Two cases (Acta Gastroenterol Latinoam 2011;41:331)
Gross description
- Yellow brown, poor to well demarcated foci of wall thickening with variable ulceration, simulates neoplasm
Gross images
Images hosted on other servers:
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
Images hosted on other servers:
Foamy macrophages and chronic inflammatory cells
Differential diagnosis
