Computed tomography diagnosis of xanthogranulomatous cholecystitis / 中华消化外科杂志

Xanthogranulomatous cholecystitis (XGC) is benign and chronic, which is rarely seen in clinical practice.The clinical and imaging presentation of XGC is similar to that of chronic cholecystitis, cholecystolithiasis and gallbladder cancer.Summarizing the computed tomography (CT) presentations of XGC is helpful in improving the diagnostic accuracy. According to the result of a retrospective analysis based on the clinical data of 17 patients with XGC, we concluded that rim enhancement sign and hypodense band sign in the arterial phase of contrast enhanced CT, and clear in interface between liver and gallbladder and trimness of internal wall in gallbladder are the CT characteristics of XGC.

A Case of Cholangiocarcinoma Suspected by Continuous Elevation of CA 19-9 after Surgery of Xanthogranulomatous Cholecystitis / 대한소화기학회지

Xanthogranulomatous cholecystitis (XGC) is an unusual and destructive inflammatory process that is characterized by thickening of the gallbladder (GB) wall with a tendency to adhere to neighboring organs. XGC is often mistaken for GB carcinoma, and the frequency of the coexistence of these two lesions is approximately 10%. Therefore, in case of severe XGC, there is chance of either overlooking the carcinoma or other significant lesions. CA 19-9 is commonly measured in the serum of patients with hepatobiliary malignancies. Although CA 19-9 can be elevated in benign conditions such as cholestasis, pancreatitis, tuberculosis, thyroid disease etc., malignancy should be considered at first in setting of its significant and persistent elevation. We report a case of a 62-year-old man who showed continuously rising level of CA19-9 over 2000 U/mL after cholecystectomy for xanthogranulomatous cholecystitis and finally was diagnosed as cholangiocarcinoma by short-term follow up.

CT Diagnosis of Xanthogranulomatous Cholecystitis:A Report of 11 Cases / 实用放射学杂志

Objective To analyze CT features of xanthogranulomatous cholecystitis(XGC)so that to improve the accuracy of diagnosis.Methods The data of CT,clinic and operation in 11 cases with XGC proved pathologically were analysed.The following CT features were analyzed:the cholecystic wall thickness,intramural hypoattenuated nodules,inner wall,mucosal line,patterns of enhancement of thickened wall,involved liver tissue and the presence of stones.The changes around the gallbladder were also noticed.Results The gallbladder wall was thickened and intramural hypoattenuated nodules were seen in all patients.The inner wall of gallbladder was smooth in 9 patients,the mucosal line was observed in 6 cases,the size of gallbladder was enlarged in 3 while 4 gallbladders were smaller than normal.Stones were found in 4 gallbladders.There were hepatic involvement in 6,pericholecystic infiltration in 3 and dilatation of biliary tract in 6 cases.Conclusion CT features of thickened gallbladder wall with intramural hypoattenuated nodules(sandwich sign)and continuous mucosal line were characteristic of XGC.