Xanthogranulomatous Cholecystitis Mimicking Carcinoma Gallbladder

Abstract

Xanthogranulomatous cholecystitis (XGC) is a rare benign chronic inflammatory disease of the gallbladder that often presents as cholecystitis and can mimic gallbladder carcinoma. Distinguishing XGC from gallbladder cancer preoperatively is challenging. We present a case of a 62-year-old male who presented with features of carcinoma gallbladder in the CECT abdomen and MRCP. Intraoperatively, there was a mass in the gallbladder and extension into the adjacent structures with involvement of the hepatic artery, 1^st part of the duodenum, portal vein, and hepatic flexure of the colon, and thus a palliative cholecystectomy was done. The histopathological report came out as XCG. The case aims to outline the clinical presentation of XGC and differentiate it from carcinoma gallbladder.

Figure 1

Magnetic resonance cholangiopancreatography (MRCP) showing thickened gallbladder.

Figure 2

Contrast-enhanced computed tomography (CECT) abdomen pelvis showing partially distended gallbladder with thickening at the region of the body with luminal narrowing.

Figure 3

Cut section of gallbladder with stone within it.

Figure 4

Histopathological examination of gallbladder wall infiltrated by histiocytes along with plasma cells and lymphocytes with multinucleated giant cells; features consistent with XCG cholecystitis.