scholarly journals A Rare Finding During a Common Procedure: Xanthogranulomatous Cholecystitis

2014 ◽  
Vol 99 (5) ◽  
pp. 595-599 ◽  
Author(s):  
Fatih Taskesen ◽  
Zulfu Arikanoglu ◽  
Omer Uslukaya ◽  
Abdullah Oguz ◽  
Ibrahim Aliosmanoglu ◽  
...  
Keyword(s):  
Open Surgery ◽  
Early Stage ◽  
Chronic Cholecystitis ◽  
Pathological Examination ◽  
Wall Thickening ◽  
Xanthogranulomatous Cholecystitis ◽  
Common Procedure ◽  
History Of ◽  
Difficult Cholecystectomy ◽  
Destructive Inflammation

Abstract Xanthogranulomatous cholecystitis is a rare variant of chronic cholecystitis characterized by severe proliferative fibrosis and accumulation of lipid-laden macrophages in regions of destructive inflammation. Xanthogranulomatous cholecystitis clinically and radiologically mimics early-stage gallbladder cancer, with wall thickening on computed tomography. The study included 14 xanthogranulomatous cholecystitis patients that were identified following retrospective analysis of the records of 1248 patients that underwent cholecystectomy between 2005 and 2011. Mean age of the 5 male and 9 female patients was 56.7 years. All 14 patients had gallbladder stones; 10 had a history of acute cholecystitis, 1 had cholangitis, and 2 presented with obstructive jaundice. A right-upper quadrant mass was palpable in 2 patients. All patients underwent cholecystectomy. Open surgery was planned and performed in 6 of the 14 patients, and laparoscopic cholecystectomy was planned in 8 patients, but was converted to open surgery in 1 case. In total, 1 patient developed wound infection, 1 patient had postoperative pneumonia, and 1 patient developed intraabdominal hematoma. None of the patients in the series died. Xanthogranulomatous cholecystitis is difficult to diagnose, both preoperatively and intraoperatively, and definitive diagnosis depends exclusively on pathological examination. Xanthogranulomatous cholecystitis should be a consideration in all difficult cholecystectomy cases.

Crohn’s disease of the gallbladder

2021 ◽  
Vol 14 (9) ◽  
pp. e243579
Author(s):  
Callam Scott ◽  
Amit Patel ◽  
Noori Maka ◽  
Jonathan C MacDonald
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Gallstone Formation ◽  
Right Hemicolectomy ◽  
Chronic Cholecystitis ◽  
Pathological Examination ◽  
Key Factors ◽  
Chronic Inflammatory Condition ◽  
History Of ◽  
Lymphoid Aggregates

Crohn’s disease (CD) is a chronic inflammatory condition, which typically involves the small and large bowel but can affect any part of the gastrointestinal tract. Common symptoms include abdominal pain, diarrhoea, fatigue, weight loss and malnutrition. Complications of CD include gallstone formation and cholecystitis. Impaired reabsorption of bile salts in the small bowel and CD-related surgeries are key factors in the development of CD-related gallstones, although other factors are also important. Direct CD-related inflammation of the gallbladder is very unusual and the typical histological features of CD are rarely encountered in cholecystectomy specimens of individuals with CD. We present a case of a man in his early 60s with CD, previous right hemicolectomy and a history of gallstones, who presented with chronic cholecystitis. Following cholecystectomy, pathological examination of the gallbladder unexpectedly demonstrated typical features of CD, including lymphoid aggregates and non-caseating mucosal granulomata.

scholarly journals A scoring system based on computed tomography for the correct diagnosis of xanthogranulomatous cholecystitis

2020 ◽  
Vol 9 (4) ◽  
pp. 205846012091823 ◽  
Author(s):  
Ryota Ito ◽  
Takashi Kobayashi ◽  
Gou Ogasawara ◽  
Yoshiharu Kono ◽  
Kazuhiko Mori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Confidence Interval ◽  
Gallbladder Cancer ◽  
Scoring System ◽  
Correct Diagnosis ◽  
Chronic Cholecystitis ◽  
Wall Thickening ◽  
Xanthogranulomatous Cholecystitis ◽  
Ct Findings ◽  
Pericholecystic Abscess

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.

scholarly journals Xanthogranulomatous cholecystitis: A clinicopathological study from a tertiary care health institution

1970 ◽  
Vol 6 (4) ◽  
pp. 472-475 ◽  
Author(s):  
PBS Kansakar ◽  
G Rodrigues ◽  
SA Khan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Preoperative Diagnosis ◽  
Open Cholecystectomy ◽  
Bladder Wall ◽  
Tertiary Care ◽  
Chronic Cholecystitis ◽  
Clinical Aspects ◽  
Wall Thickening ◽  
Xanthogranulomatous Cholecystitis

Background: Xanthogranulomatous cholecystitis is an unusual and destructive form of chronic cholecystitis and is indistinguishable from other forms of cholecystitis which makes preoperative diagnosis and surgery difficult. Objectives: To review the demographic and clinical aspects of xanthogranulomatous cholecystitis; to study the possibility of preoperative diagnosis and to identify the causes for difficult surgery. Materials and methods: All cases histopathologically diagnosed as xanthogranulomatous cholecystitis over a period of six years from October 1999 to September 2005 at Kasturba Medical College Hospital, Manipal, India were included in the study. Data of the patients was collected retro and prospectively. Results: A total of 615 patients underwent cholecystectomy out of which 33 (5.2%) were diagnosed to have xanthogranulomatous cholecystitis. Ultrasound abdomen showed gallbladder wall thickening in 19 (57.5%) cases and gallstones in 32 (96.9%) cases. Thirty (90.9%) underwent open cholecystectomy. Gallbladder could be removed totally in 25 (75.6%) cases whereas five (15.2%) had to undergo partial cholecystectomy and in one patient, only cholecystostomy could be performed due to dense adhesions. Laparoscopic cholecystectomy was attempted in 11 patients but successful only in two patients with a conversion rate of 81.8%. Postoperative wound infection was seen in five (15.1%) patients and one (3%) had minor biliary leak which was treated conservatively. Histologically, xanthogranulomatous cholecystitis was associated with malignancy in one (3.03%) patient. There was no mortality. Conclusion: Clinical presentation of xanthogranulomatous cholecystitis was indistinguishable from chronic cholecystitis. Ultrasonography may reveal only non specific findings of calculi and thickened gall bladder wall. Hence preoperative diagnosis is unlikely. Cholecystectomy was usually difficult owing to dense adhesions of gallbladder and Calot's triangle. Conversion rate of laparoscopic cholecystectomy is higher. Morbidity associated with surgery is significant. Key words: Xanthogranulomatous cholecystitis, Cholecystectomy, Malignancy doi: 10.3126/kumj.v6i4.1738   Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 472-475

Stage I seminoma: Treatment outcomes in a low-income country.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15024-e15024
Author(s):  
Yazan Asad Abuodeh ◽  
Fadwa Abdelrahman ◽  
Ahmed Abdel-Fattah Salem ◽  
Naim Farah ◽  
Abdelatif Al-Mousa ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Developing Country ◽  
Low Income ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Pathological Examination ◽  
Cancer Center ◽  
Prior History ◽  
History Of

e15024 Background: The aim of this report is to address treatment outcomes of patients with early-stage seminoma in a developing country with special reference to patients with history of surgical violation of the scrotum and the potential predictors of disease relapse. Methods: Seventy four patients with pure seminoma were treated at King Hussein Cancer Center (Amman, Jordan) between 2003 and 2010. All patients underwent orchiectomy. All but 3 patients received adjuvant radiotherapy. Patients who underwent surgical violation of the scrotum prior to referral were managed by further excision or irradiation of the scrotal scar. The follow-up ranged from 1 to 200 months (mean, 33 months). Results: At the time of follow-up; all but one patient remain alive. The 3-year relapse-free survival for the entire cohort was 95.9%. Three patients were burdened by relapse, all of whom received adjuvant irradiation following inguinal orchiectomy and initially harbored tumors larger than 4cm upon pathological examination. Median time to relapse was 14 months (range, 8-25 months). None were associated with elevated tumor markers prior to detection of relapse. All but one patient were successfully salvaged by chemotherapy. Conclusions: Our results confirm the excellent prognosis for patients with early-stage seminoma treated by orchiectomy and adjuvant radiotherapy in a developing country. Although all patients burdened by relapse demonstrated adverse pathological findings upon initial assessment, no consistent predictor of relapse was found. Scrotal scar re-excision or irradiation in patients with prior history of surgical violation of the scrotum are effective in preventing local failure.

scholarly journals Distinguishing Xanthogranulomatous Cholecystitis from the Wall-Thickening Type of Early-Stage Gallbladder Cancer

Gut and Liver ◽  
2010 ◽  
Vol 4 (4) ◽  
pp. 518-523 ◽  
Author(s):  
Byung Jin Chang ◽  
Seong Hyun Kim ◽  
Ho Yong Park ◽  
Seong Woo Lim ◽  
Jeong Kim ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Early Stage ◽  
Wall Thickening ◽  
Xanthogranulomatous Cholecystitis

The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

2016 ◽  
Vol 19 (1) ◽  
pp. 023 ◽  
Author(s):  
Mehmet Yildirim ◽  
Recep Ustaalioglu ◽  
Murat Erkan ◽  
Bala Basak Oven Ustaalioglu ◽  
Hatice Demirbag ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Pericardial Tamponade ◽  
Pericardial Fluid ◽  
Pathological Examination ◽  
Common Disease ◽  
Pericardial Window ◽  
Surgical Interventions ◽  
History Of ◽  
Recurrent Pericardial Effusion

<strong>Background:</strong> Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. <br /><strong>Methods:</strong> We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. <br /><strong>Results:</strong> Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. <br /><strong>Conclusion:</strong> Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

ABOUT THE PERIODIZATION AND CHRONOLOGY OF THE HISTORY OF TAURIC CHERSONESUS IN THE PRE-ROMAN AND THE LATE ANTIQUE PERIODS

2020 ◽  
Vol 6 (72) (3) ◽  
pp. 127-148
Author(s):  
S. V. Ushakov
Keyword(s):  
Scientific Literature ◽  
Early Stage ◽  
Late Antique ◽  
Ancient History ◽  
History Of ◽  
Transitional Time ◽  
Early Byzantine

Hundreds of scientific works are devoted to the study of the Tauric Chersonesus, but the problem of chronology and periodization of its ancient history is not sufficiently developed in historiography. Analysis of scientific literature and a number of sources concerning this subject allows to define the chronological framework and to reveal 10 stages of the history of ancient Chersonesos (as a preliminary definition). The early stage, the Foundation and formation of the Polis, is defined from the middle/last third of the VI century (or the first half of the V century BC) to the end of the V century BC. The end of the late-Antique − early-Byzantine (transitional) time in Chersonesos can be attributed to the second half of the VI – first third of the VII centuries ad).

HIGHER EDUCATION IN ANCIENT INDIA

2018 ◽  
Vol 6 (26) ◽  
Author(s):  
Satyendra Singh Chahar ◽  
Nirmal Singh
Keyword(s):  
Cultural History ◽  
Early Stage ◽  
University Education ◽  
Educational Institutions ◽  
Educational Method ◽  
Men And Women ◽  
Ancient India ◽  
Herbert Spencer ◽  
History Of ◽  
The Ideal

University education -on almost modern lines existed in India as early as 800 B.C. or even earlier. The learning or culture of ancient India was chiefly the product of her hermitages in the solitude of the forests. It was not of the cities. The learning of the forests was embodied in the books specially designated as Aranyakas "belonging to the forests." The ideal of education has been very grand, noble and high in ancient India. Its aimaccording to Herbert Spencer is the 'training for completeness of life' and ‘the molding o character of men and women for the battle of life’. The history of the educational institutions in ancient India shows a glorious dateline of her cultural history. It points to a long history altogether. In the early stage it was rural, not urban. British Sanskrit scholar Arthur Anthony Macdonell says "Some hundreds of years must have been needed for all that is found" in her culture. The aim of education was at the manifestation of the divinity in men, it touches the highest point of knowledge. In order to attain the goal the whole educational method is based on plain living and high thinking pursued through eternity.

The diagnosis of early pneumoconiosis in dust-exposed workers: comparison of chest radiography and computed tomography

2021 ◽  
pp. 028418512110225
Author(s):  
Hideyuki Hayashi ◽  
Kazuto Ashizawa ◽  
Masashi Takahashi ◽  
Katsuya Kato ◽  
Hiroaki Arakawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Chest Radiography ◽  
Pulmonary Emphysema ◽  
Early Stage ◽  
Pathological Changes ◽  
Occupational History ◽  
Exposed Workers ◽  
History Of ◽  
Ct Data ◽  
Positive Results

Background Chest radiography (CR) is employed as the evaluation of pneumoconiosis; however, we sometimes encounter cases in which computed tomography (CT) is more effective in detecting subtle pathological changes or cases in which CR yields false-positive results. Purpose To compare CR to CT in the diagnosis of early-stage pneumoconiosis. Material and Methods CR and CT were performed for 132 workers with an occupational history of mining. We excluded 23 cases of arc-welder’s lung. Five readers who were experienced chest radiologists or pulmonologists independently graded the pulmonary small opacities on CR of the remaining 109 cases. We then excluded 37 cases in which the CT data were not sufficient for grading. CT images of the remaining 72 cases were graded by the five readers. We also assessed the degree of pulmonary emphysema in those cases. Results The grade of profusion on CR (CR score) of all five readers was identical in only 5 of 109 cases (4.6%). The CR score coincided with that on CT in 40 of 72 cases (56%). The CT score was higher than that on CR in 13 cases (18%). On the other hand, the CT score was lower than that on CR in 19 cases (26%). The incidence of pulmonary emphysema was significantly higher in patients whose CR score was higher than their CT score. Conclusion CT is more sensitive than CR in the evaluation of early-stage pneumoconiosis. In cases with emphysema, the CR score tends to be higher in comparison to that on CT.

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