Xanthogranulomatous cholecystitis mimicking gallbladder carcinoma: An analysis of 42 cases

Figure 1 The surgical procedures for the 42 cases of xanthogranulomatous cholecystitis. XGC: Xanthogranulomatous cholecystitis; GBC: Gallbladder carcinoma; IFS: Intra-operative frozen section analysis; TC: Total cholecystectomy; SC: Subtotal cholecystectomy; CBD: Common bile duct.

Figure 2 A 50-year-old woman with xanthogranulomatous cholecystitis misdiagnosed as gallbladder carcinoma based on computed tomography findings. A: Contrast-enhanced computed tomography shows the diffuse gallbladder wall thickening with intramural hypo-attenuated nodules (arrows) and heterogeneous enhancement in hepatic parenchyma neighboring gallbladder, indicating gallbladder carcinoma with direct liver invasion; B: Macroscopic examination of gallbladder specimen revealed multiple yellow nodules and bands in the wall (arrows). The gallbladder was sent for intra-operative frozen section (FS) analysis and demonstrated inflammatory lesions; C: Based on the FS diagnosis, a simple cholecystectomy was performed. Note that no macroscopic hepatic invasion was found (arrows). Ultimately, xanthogranulomatous cholecystitis was diagnosed by the pathological examination. CDS: Cystic duct stump; CBD: Common bile duct.