A Clinical Analysis on Patients with Xanthogranulomatous Cholecystitis

Song, Seung Ho; Nam, Seung Woo; Roe, Im Hwan; Kim, Jung Won; Lim, Chang Young; Chang, Hyo Shick; Shin, Ki Chul; Shin, Hyun Deok; Kim, Jung Taik; Shin, Yong Moon; Kim, Eo Jin

Abstract

BACKGROUND/AIMS: Xanthogranulomatous cholecystitis (XGC) is an uncommon inflammatory disease of the gallbladder (GB). It is characterized by foamy histiocyte infiltration and increasing fibrosis. The purpose of this study was to evaluate clinical features of XGC correlating to radiological and surgical findings. METHODS: We retrospectively reviewed six histologically proven cases (0.93%) of XGC among 644 cholecystectomy specimens that were collected from January 1995 to July 2001. We analyzed the clinical data on associated diseases, laboratory findings, radiological findings, perioperative courses, operative findings and pathological findings. RESULTS: There were five males and one female. Their mean age was 65.5+/-7.3 years. Gallstones were present in five patients and four of them had black pigment stones. Stones of one patient were unclassified, and the patient without gallstone was associated with blunt abdominal trauma. Radiological and pathological findings in all six patients showed GB wall thickening (four diffuse and two focal patterns). Intramural hypoattenuated nodules were observed in three patients. Five patients showed preoperative complications such as GB empyema (3 cases), fistula (1 case) and adhesion (4 cases). CONCLUSIONS: The patients with XGC show a chronic inflammatory process with a high frequency of preoperative complications. Further studies are needed to clarify the pathological correlation between characteristics of gallstones and XGC.