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Xanthogranulomatous cholecystitis

Case contributed by Raad Al Tahat
Diagnosis probable

Presentation

Right upper quadrant pain associated with nausea and vomiting.

Patient Data

Age: 70 years
Gender: Male

Abdomen and pelvis

ct

Markedly distended gallbladder abutting the anterior abdominal wall; with 2.5 x 1.4 cm gallstone impacted in the gallbladder neck.

Diffuse wall thickening associated with intramural hypo-attenuating nodules of varying sizes.

Peri cholecystic inflammatory fat stranding.

Multiple enlarged intra-abdominal lymph nodes, particularly in porta hepatis, pre caval, par aortic and aortocaval groups.

Case Discussion

Xanthogranulomatous cholecystitis is a rare inflammatory disease of the gallbladder characterized by a focal, diffuse destructive inflammatory process with an accumulation of lipid-laden macrophages.

It may simulate a malignancy radiologically and pathologically. 

The presence of hypo-attenuating nodules within the thickened gallbladder wall favors xanthogranulomatous cholecystitis.  

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