Presentation
Right upper quadrant pain associated with nausea and vomiting.
Patient Data
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.