Xanthogranulomatous cholecystitis is a rare form of chronic cholecystitis that its clinical presentation, radiological and even can simulate a macroscopic cancer of the gallbladder. the etiology remains unclear, the most plausible hypothesis is a chronic infection of the gallbladder with default discharge of bile. We report a case of xanthogranulomatous cholecystitis operated with the diagnosis of suspected cancer of the gallbladder and whose diagnosis was established by histological examination.
This is the patient KN 63ans old admitted through the emergency room for care more defense dune pain right hypochondrium with vomiting and fever 38.3 ° C and leukocytosis with biology.
An ultrasound abdominal which objective was achieved: a calculous gallbladder wall thickening seat cubicle hypoechogene The patient was admitted for treatment acute calculous cholecystitis dune.
After a treatment based on antibiotics and analgesics was performed abdominal scanner which aim thickened gallbladder lithiasis with invasion of segment4 with the presence of several nodes pedicle; gallbladder suspicious?
The patient was operated on eight days after admission for acute gallstone cholecystitis (gallbladder suspect) n extemporaneous examination was not available, anapath final specimen is returned for fibrous reaction with an inflammatory granuloma multiforme rich histiocytic cells and absence of any sign of malignancy: This aspect was in favor of xanthogranulomatous cholecystitis
Xanthogranulomatous cholecystitis is a rare form of chronic cholecystitis can simulate gallbladder cancer biliary both clinically, radiologically as macroscopically. While the etiology remains unclear, the most plausible is a chronic infection the absence of gallbladder with bile evacuation.
Despite advances in medical imaging, the diagnosis of xanthogranulomatous cholecystitis, in its pseudo-tumor remains difficult preoperatively. The differential diagnosis especially with gallbladder cancer, which can lead to a disproportionate surgery
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Posted by: zatir soufiane, general surgeon, militery university hospital oran, Algeria (09-Nov-2012)