Xanthogranulomatous Cholecystitis and Gallbladder Cancer: Two Diseases with Difficult Differential Diagnoses

Background Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis. The differential diagnoses of XGC include gallbladder cancer (GBC), adenomyomatosis, and actinomycosis of the gallbladder. Purpose To assess the usefulness of computed tomography (CT) findings in the diagnosis of XGC and differentiation from GBC. Material and Methods We retrospectively assessed the pathological and radiological records of 13 patients with pathologically proven XGC and 33 patients with GBC. Results Significant differences were observed for the following five CT findings: diffuse wall thickening (XGC = 85%, GBC = 15%, P < 0.01); absence of polypoid lesions (XGC = 100%, GBC = 48%, P < 0.01); intramural nodules or bands (XGC = 54%, GBC = 9%, P < 0.01); pericholecystic infiltration (XGC = 69%, GBC = 9%, P < 0.01); and pericholecystic abscess (XGC = 23%, GBC = 0%, P = 0.018). We defined the scoring system based on how many of the five CT findings were observed. Our scoring system, which included these findings, revealed that patients with three or more findings had sensitivity of 77% (95% confidence interval [CI] = 57–87) and specificity of 94% (95% CI = 86–98). Conclusion Our scoring system can assist in the differentiation of XGC from GBC.

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Xanthogranulomatous Cholecystitis Suspected as Metastatic Gallbladder Cancer

Korean Journal of Gastroenterology ◽

10.4166/kjg.2021.026 ◽

2021 ◽

Vol 77 (3) ◽

pp. 141-144

Author(s):

Jaeho Han ◽

Sangjeong Ahn ◽

In Rae Cho

Keyword(s):

Gallbladder Cancer ◽

Xanthogranulomatous Cholecystitis

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Xanthogranulomatous Cholecystitis Masquerading As Gallbladder Cancer: A Diagnostic Dilemma

Journal of Interdisciplinary Histopathology ◽

10.5455/jihp.20130508102420 ◽

2013 ◽

Vol 1 (5) ◽

pp. 280

Author(s):

Faten Limaiem ◽

Beya Chelly ◽

Sadri Abid ◽

Emna Boudabous ◽

Ahlem Lahmar ◽

...

Keyword(s):

Gallbladder Cancer ◽

Xanthogranulomatous Cholecystitis ◽

Diagnostic Dilemma

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Prevalence and intraoperative characteristics of Florid Xanthogranulomatous Cholecystitis mimic Gallbladder Cancer in a single tertiary care medical city in Saudi Arabia.

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2019.11.297 ◽

2020 ◽

Vol 46 (2) ◽

pp. e117-e118

Author(s):

Maram Alawad

Keyword(s):

Saudi Arabia ◽

Gallbladder Cancer ◽

Tertiary Care ◽

Xanthogranulomatous Cholecystitis ◽

Medical City

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Xanthogranulomatous Cholecystitis Masquerading as Gallbladder Cancer: Can It Be Diagnosed Preoperatively?

Gastroenterology Research and Practice ◽

10.1155/2014/253645 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 9

Author(s):

Ashwin Rammohan ◽

Sathya D. Cherukuri ◽

Jeswanth Sathyanesan ◽

Ravichandran Palaniappan ◽

Manoharan Govindan

Keyword(s):

Gallbladder Cancer ◽

Preoperative Diagnosis ◽

Histopathological Examination ◽

Radical Resection ◽

Gallbladder Wall ◽

Wall Thickening ◽

Xanthogranulomatous Cholecystitis ◽

Radiological Features ◽

Group A ◽

Group B

Background. Xanthogranulomatous cholecystitis (XGC) is often misdiagnosed as gallbladder cancer (GBC). We aimed to determine the preoperative characteristics that could potentially aid in an accurate diagnosis of XGC masquerading as GBC.Methods. An analysis of patients operated upon with a preoperative diagnosis of GBC between January 2008 and December 2012 was conducted to determine the clinical and radiological features which could assist in a preoperative diagnosis of XGC.Results. Out of 77 patients who underwent radical cholecystectomy, 16 were reported as XGC on final histopathology (Group A), while 60 were GBC (Group B). The incidences of abdominal pain, cholelithiasis, choledocholithiasis, and acute cholecystitis were significantly higher in Group A, while anorexia and weight loss were higher in Group B. On CT, diffuse gallbladder wall thickening, continuous mucosal line enhancement, and submucosal hypoattenuated nodules were significant findings in Group A. CT findings on retrospect revealed at least one of these findings in 68.7% of the cases.Conclusion. Differentiating XGC from GBC is difficult, and a definitive diagnosis still necessitates a histopathological examination. An accurate preoperative diagnosis requires an integrated review of clinical and characteristic radiological features, the presence of which may help avoid radical resection and avoidable morbidity in selected cases.

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