Xanthogranulomatous cholecystitis(XGC) is a rare, benign, destructive, inflammatory process of the gallbladder that is believed tobe a variant of chronic cholecystitis. The gross and microscopic appearances are characteristic with multiple
intramural
nodules composed of foamy histiocytes and inflammatory cells. Clinically, radiologically, and morphologically, XGC is sometimes confused as a malignant neoplasm. In a retrospective twelve year study, 20 cases of XGC were found in 2007
gallbladders(0.99%) and we have reviewed the characteristic features of it. In 8 patients(40%) XGC sufficiently resembled carcinoma of the gallbladder for the radiological study and surgery. Gallstones were found in 14 cases(70%).
Associated malignancy comprised 2 cases : one in distal CBD and one in the head of pancreas, but, there was no coexistent carcinoma of the gallbladder. Complete cholecystectomy was done in 12 cases(60%) and partial cholecystectomy was performed
in
7
cases(35%). One underwent T-tube choledochostomy only for suspected carcinoma of the gallbladder, which subsequently proved to be XGC. In conclusion, appearances often mimicked carcinoma of the gallbladder at laparotomy with xanthogranulomatous
tissue
extending to adjacent structures. Therefore, the possibility should be considered that frozen-section biopsy may confirm. If XGC was suspected at operation or confirmed at frozen-section biopsy, coincident carcinoma may still be present.
Management
of
XGC should therefore include choloecystectomy and excision of adjacent xanthogranulomatous tissue and any fistula.
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