Xanthogranulomatous cholecystits in 2-month-old infant
- Affiliations
-
- 1Department of Pediatric Surgery, Pusan National University Children's Hospital, Yangsan, Korea.
- 2Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea. spkhy02@snu.ac.kr
- 3Department of Pediatric Radiology, Seoul National University Children's Hospital, Seoul, Korea.
- 4Department of Pathology, Seoul National University Hospital, Seoul, Korea.
- KMID: 2096711
- DOI: http://doi.org/10.4174/jkss.2013.85.4.191
Abstract
- Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic cholecystitis that is accompanied by xanthomatous histiocytes and chronic inflammation. A 2-month-old boy presented with a right upper abdominal palpable mass. Cholecystectomy with liver wedge resection was done, under the impression that the mass might be a hepatic tumor or liver abscess. Pathologic examination showed XGC with abscess formation. Most cases of XGC were observed in adult and only a few cases were reported in children. We describe a very rare case of XGC in infancy.
MeSH Terms
Figure
-
Fig. 1 Transverse ultrasonographic scan shows a heterogeneous hypoechoic mass at the gallbladder (GB) fossa. Small hypoechoic lesion is also noted at the anterior abdominal wall (arrow). Neither GB nor cholelithiasis is visible.
Fig. 2 (A, B) Axial and sagittal enhanced T1-weighted images show a multilobulated mass with heterogeneous enhancement at the inferior and anterior aspect of the liver. There are multiple nonenhancing areas suggesting abscess pockets within the mass. Anterior abdominal wall adjacent to the mass is also involved (arrowheads). The surface of the liver shows indentation by the mass. The gallbladder is not seen on magnetic resonance imaging.
Fig. 3 (A) Gallbladder is surrounded by mononuclear inflammatory cells such as lymphoplasma cells and foamy macrophages (H&E, ×40). (B) Xanthoid cell (foamy macrophage) infiltration is remarkable (H&E, ×600). (C) CD68 immunostaining for macrophages shows heavy infiltration of macrophages around gallbladder wall (×2). (D) CK 7 immunostaining revealed gallbladder mucosa and bile ducts (arrows) in liver parenchyma (×1).
Reference
-
1. Goodman ZD, Ishak KG. Xanthogranulomatous cholecystitis. Am J Surg Pathol. 1981; 5:653–659.2. Christensen AH, Ishak KG. Benign tumors and pseudotumors of the gallbladder. Report of 180 cases. Arch Pathol. 1970; 90:423–432.3. McCoy JJ Jr, Vila R, Petrossian G, McCall RA, Reddy KS. Xanthogranulomatous cholecystitis: report of two cases. J S C Med Assoc. 1976; 72:78–79.4. Kim H, Cho Y, Park J. Xanthogranulomatous cholecystitis not associated with gallstone in a 9-year-old girl. J Korean Surg Soc. 2009; 77:72–74.5. Dixit VK, Prakash A, Gupta A, Pandey M, Gautam A, Kumar M, et al. Xanthogranulomatous cholecystitis. Dig Dis Sci. 1998; 43:940–942.6. Pinocy J, Lange A, Konig C, Kaiserling E, Becker HD, Krober SM. Xanthogranulomatous cholecystitis resembling carcinoma with extensive tumorous infiltration of the liver and colon. Langenbecks Arch Surg. 2003; 388:48–51.7. Roberts KM, Parsons MA. Xanthogranulomatous cholecystitis: clinicopathological study of 13 cases. J Clin Pathol. 1987; 40:412–417.8. Benbow EW. Xanthogranulomatous cholecystitis. Br J Surg. 1990; 77:255–256.9. Houston JP, Collins MC, Cameron I, Reed MW, Parsons MA, Roberts KM. Xanthogranulomatous cholecystitis. Br J Surg. 1994; 81:1030–1032.10. Kawana T, Suita S, Arima T, Hirayama Y, Ishii K, Minamishima I, et al. Xanthogranulomatous cholecystitis in an infant with obstructive jaundice. Eur J Pediatr. 1990; 149:765–767.
