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Ultrasound demonstration of xanthogranulomatous cholecystitis

โœ Scribed by Jeffrey B. Lichtman; Vijay A. Varma

Publisher
John Wiley and Sons
Year
1987
Tongue
English
Weight
400 KB
Volume
15
Category
Article
ISSN
0091-2751

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โœฆ Synopsis

Xanthogranulomatous cholecystitis is a relatively rare entity. A search of the radiologic literature revealed only two previous An example of this entity is presented with ultrasound and pathologic correlation.

CASE REPORT

A 62-year-old man with a long history of recurrent pancreatitis secondary to alcohol abuse developed vomiting and right-sided abdominal pain. His WBC was 15,000 with 76 segs and 3 bands. Serum amylase was within normal limits.

An ultrasound examination showed a moderately distended gallbladder filled with finely echogenic nonshadowing material. The gallbladder wall appeared thickened and generally sonolucent, with one discrete, rounded, relatively sonolucent intramural nodule (Fig. 1). The common bile duct measured 8 mm in diameter.

The patient was treated with intravenous antibiotics, resulting in defervescense of his fever and decrease in the WBC. Three weeks after admission, a cholecystectomy was performed, which demonstrated the gallbladder to be densely encased in inflammatory tissue. No gallstones were indicated in the surgical or pathology reports.

The past history was relevant in that 6 years previously, a sphincteroplasty had been performed for fibrosis caused by chronic pancreatitis.

On gross pathologic examination, the gallbladder wall was markedly thickened, measuring 0.4 cm to 0.8 cm. A 1.8 cm x 0.8 cm x 0.8 cm oval intramural nodule with no apparent connection to overlying mucosa was found (Fig. 2A). It was

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