1.A case of xanthogranulomatous cholecystitis.
Young Eun JOO ; Je Jung LEE ; Ik Joo CHUNG ; Hyun Soo KIM ; Jong Sun REW ; Hyun Jong KIM ; Sang Woo JUHNG ; Sei Jong KIM
The Korean Journal of Internal Medicine 1999;14(2):90-93
Xanthogranulomatous cholecystitis (XGC) is an uncommon, focal or diffuse destructive inflammatory disease of the gallbladder that is assumed to be a variant of conventional chronic cholecystitis. A 36-year-old male was admitted to Chonnam National University Hospital with a 10-day history of right upper quadrant pain with fever. 15 years ago, he was first diagnosed as having hemophilia A, and has been followed up in the department of Hematology. Computed tomogram (CT) revealed a well-marginated, uniform, marked wall thickening of the gallbladder with multiseptate enhancement. Magnetic resonance imaging (MRI) demonstrated diffuse wall thickening of the gallbladder by viewing high signal foci with signal void lesions. After factor VIII replacement, exploration was done. On operation, the gallbladder wall was thickened and the serosa were surrounded by dense fibrous adhesions which were often extensive and attached to the adjacent hepatic parenchyma. There was a small-sized abscess in the gallbladder wall near the cystic duct. Dissection between the gallbladder serosa and hepatic parenchyma was difficult. Cross sections through the wall revealed multiple yellow-colored, nodule-like lesions ranging from 0.5-2 cm. There were also multiple black pigmented gallstones ranging from 0.5-1 cm. The pathologic findings showed the collection of foamy histiocytes containing abundant lipid in the cytoplasm and admixed lymphoid cells. Histologically, it was confirmed as XGC. We report a case with XGC mimicking gallbladder cancer in a hemophilia patient.
Adult
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Case Report
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Cholecystitis/radiography
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Cholecystitis/pathology*
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Cholecystitis/diagnosis
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Gallbladder/ultrasonography
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Gallbladder/pathology
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Histiocytes/pathology
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Human
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Magnetic Resonance Imaging
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Male
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Tomography, X-Ray Computed
2.Steatocholecystitis.
Kang Nyeong LEE ; Ho Soon CHOI
The Korean Journal of Gastroenterology 2010;55(6):347-349
No abstract available.
Aged
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Cholecystitis/*diagnosis/radiography/ultrasonography
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Endosonography
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Fatty Liver/pathology
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Female
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Humans
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Recurrence
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Tomography, X-Ray Computed
3.Focal Thickening at the Fundus of the Gallbladder: Computed Tomography Differentiation of Fundal Type Adenomyomatosis and Localized Chronic Cholecystitis.
Bo Sung KIM ; Jong Young OH ; Kyung Jin NAM ; Jin Han CHO ; Hee Jin KWON ; Seong Kuk YOON ; Jin Sook JEONG ; Myung Hwan NOH
Gut and Liver 2014;8(2):219-223
BACKGROUND/AIMS: The objective of our study was to identify useful computed tomography (CT) findings for differentiating fundal type adenomyomatosis from localized chronic cholecystitis involving the fundus of the gallbladder. METHODS: We retrospectively identified cases of 41 patients with pathologically proven adenomyomatosis (n=21) or chronic cholecystitis (n=20) who had fundal thickening of the gallbladder on preoperative abdominal CT. Analysis of the CT findings included evaluation of the thickness, contour, border, intralesional cystic area, adjacent gallbladder wall thickening, presence of inner layer enhancement, enhancement grade, enhancement pattern, and presence of stones. Statistical analyses were performed using the Mann-Whitney U test and Fisher exact test. RESULTS: Oval contour, inner layer enhancement and intralesional cystic area were more frequently noted in adenomyomatosis than in chronic cholecystitis (p<0.05 for each finding). Flat contour and adjacent gallbladder wall thickening were more frequently observed in chronic cholecystitis than in adenomyomatosis. No differences between adenomyomatosis and chronic cholecystitis in terms of the thickness, enhancement grade, enhancement pattern and presence of stones were apparent. CONCLUSIONS: CT may help to differentiate fundal type adenomyomatosis from localized chronic cholecystitis involving the fundus of the gallbladder.
Adenomyoma/*pathology/radiography
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Adult
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Aged
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Cholecystitis/*pathology/radiography
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Chronic Disease
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Diagnosis, Differential
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Female
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Gallbladder
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Gallbladder Neoplasms/*pathology/radiography
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Humans
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Male
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Middle Aged
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Retrospective Studies
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Tomography, X-Ray Computed
4.A Case of Cholangiocarcinoma Suspected by Continuous Elevation of CA 19-9 after Surgery of Xanthogranulomatous Cholecystitis.
Sang Youn HWANG ; Joon Suk KIM ; Ji Bong JEONG ; Ji Won KIM ; Byeong Gwan KIM ; Kook Lae LEE ; Young Joon AHN ; Mee Soo CHANG
The Korean Journal of Gastroenterology 2010;55(6):404-409
Xanthogranulomatous cholecystitis (XGC) is an unusual and destructive inflammatory process that is characterized by thickening of the gallbladder (GB) wall with a tendency to adhere to neighboring organs. XGC is often mistaken for GB carcinoma, and the frequency of the coexistence of these two lesions is approximately 10%. Therefore, in case of severe XGC, there is chance of either overlooking the carcinoma or other significant lesions. CA 19-9 is commonly measured in the serum of patients with hepatobiliary malignancies. Although CA 19-9 can be elevated in benign conditions such as cholestasis, pancreatitis, tuberculosis, thyroid disease etc., malignancy should be considered at first in setting of its significant and persistent elevation. We report a case of a 62-year-old man who showed continuously rising level of CA19-9 over 2000 U/mL after cholecystectomy for xanthogranulomatous cholecystitis and finally was diagnosed as cholangiocarcinoma by short-term follow up.
Bile Duct Neoplasms/*diagnosis/pathology/radiography
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*Bile Ducts, Intrahepatic
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CA-19-9 Antigen/*blood
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Cholangiocarcinoma/*diagnosis/pathology/radiography
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Cholecystitis/pathology/*surgery
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Granuloma/pathology/*surgery
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Humans
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Male
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Middle Aged
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Positron-Emission Tomography
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Tomography, X-Ray Computed
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Xanthomatosis/pathology/*surgery
5.Simultaneous Xanthogranulomatous Cholecystitis and Gallbladder Cancer in a Patient with a Large Abdominal Aortic Aneurysm.
Yahya AL-ABED ; Mohammed ELSHERIF ; John FIRTH ; Rudi BORGSTEIN ; Fiona MYINT
The Korean Journal of Internal Medicine 2012;27(3):338-341
There have been reports of the coexistence of abdominal aortic aneurysm (AAA) with intra-abdominal malignancy including gastric, colonic, pancreatic, and renal. We herein report a case of a previously undiagnosed AAA and a presenting complaint consistent with acute cholecystitis. Following cholecystectomy, this was noted to be a rare form of chronic cholecystitis: xanthogranulomatous cholecystitis. There is a known possible association of this uncommon condition with gallbladder cancer. The management of concomitant pathologies can present a real challenge to the multidisciplinary team, especially with large aneurysms.
Adenocarcinoma/*complications/radiography/secondary/surgery
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Aged
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Aortic Aneurysm, Abdominal/*complications/radiography/surgery
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Biopsy
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Blood Vessel Prosthesis Implantation
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Cholecystectomy
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Cholecystitis/*complications/pathology/radiography/surgery
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Endovascular Procedures
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Female
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Gallbladder Neoplasms/*complications/pathology/radiography/surgery
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Granuloma/*complications/pathology/radiography/surgery
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Humans
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Tomography, X-Ray Computed
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Treatment Outcome
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Xanthomatosis/*complications/pathology/radiography/surgery