1/25. Endoscopic sonography in the diagnosis of xanthogranulomatous cholecystitis.Xanthogranulomatous cholecystitis (XGC) is an unusual inflammatory disease of the gallbladder that may simulate gallbladder cancer. We report the findings with conventional sonography, endoscopic sonography (EUS), and CT in 3 cases of XGC. EUS could visualize hyperechoic nodules in the gallbladder wall, probably representing xanthogranulomas, but loss of the multilayered structure of the gallbladder wall and infiltration into adjacent organs make differentiating XGC from gallbladder cancer difficult with EUS alone.- - - - - - - - - - ranking = 1keywords = gallbladder (Clic here for more details about this article) |
2/25. Acute granulomatous schistosomal cholecystitis.Schistosomal cholecystitis is a rare entity with less than 10 cases described in the medical literature [1-3]. It is unclear whether schistosomal eggs deposited in the wall of the gallbladder trigger a clinically manifest acute cholecystitis, since most of the cases described were also found to have concomitant gallstones. Herein, we report a patient who developed acute schistosomal granulomatous acalculous cholecystitis. The clinical presentation, chronology of events and pathological findings strongly support the association between cholecystitis and schistosomal infection.- - - - - - - - - - ranking = 0.2keywords = gallbladder (Clic here for more details about this article) |
3/25. The vesical granuloma: rare and late complication of laparoscopic cholecystectomy.The spillage of gallstones into the peritoneal cavity from iatrogenic perforation of the gallbladder that occurs during laparoscopic cholecystectomy can result in late and serious complications. We report a case of vesical granuloma with symptoms of dysuria, pollakiuria, and vesical tenesmus that occurred 23 months after a laparoscopic cholecystectomy. Preoperative diagnostic evaluation showed a 3-cm vesical neoformation. A partial cystectomy was performed; macroscopic and histologic examination documented a central nidus of fragmented gallstones and a picture of chronic granulomatous inflammation. Although complications related to unretrieved gallstones that spill into the peritoneal cavity during laparoscopic cholecystectomy are rare, they are being reported with increasing frequency. Therefore, it is important to use tools and techniques that prevent lacerations of the gallbladder and involve retrieval of spilled gallstones.- - - - - - - - - - ranking = 0.4keywords = gallbladder (Clic here for more details about this article) |
4/25. Xanthogranulomatous cholecystitis with a liver abscess and metastatic endophthalmitis: report of a case.There have been no reported cases of xanthogranulomatous cholecystitis with a liver abscess and metastatic endophthalmitis in the literature. There has been only one other case of xanthogranulomatous cholecystitis associated with a liver abscess in japan prior to the present report. A 53-year-old man was admitted to a local hospital complaining of high fever. Abdominal ultrasonography and computed tomography showed a liver abscess. After percutaneous transhepatic abscess drainage, he complained of an abnormal sensation in his left eyeball and was diagnosed to have endophthalmitis. After being treated for the endophthalmitis, he was referred to our hospital to have the liver abscess evaluated. Endoscopic retrograde cholangiopancreatography showed a normal biliary system without any communication with the liver abscess. Two weeks after endoscopic retrograde cholangiopancreatography he complained of right hypochondralgia. ultrasonography revealed the presence of sludge in the swollen gallbladder. Under a diagnosis of cholecystitis with a liver abscess, a cholecystectomy was performed. A histological examination indicated xanthogranulomatous cholecystitis based on the findings of a granulomatous lesion consisting of foamy cells in the gallbladder wall. We herein present the first known case of xanthogranulomatous cholecystitis with a liver abscess and metastatic endophthalmitis, while also making a review of the literature.- - - - - - - - - - ranking = 0.4keywords = gallbladder (Clic here for more details about this article) |
5/25. Genetic analysis of xanthogranulomatous cholecystitis: precancerous lesion of gallbladder cancer?Xanthogranulomatous Cholecystitis is a chronic inflammatory disease of the gallbladder, a variant of the chronic cholecystitis. As xanthogranulomatous cholecystitis is occasionally seen with carcinoma of the gallbladder, the association with cancer is a controversial issue. A focal type of xanthogranulomatous cholecystitis is found simultaneously with gastric cancer diagnosed preoperatively. The resected specimen was genetically studied. polymerase chain reaction amplification, single-strand conformational polymorphism analysis for mutation of p53 showed no abnormality indicating that less association with cancer in which the mutation of p53 is often seen. Etiopathologic factors of xanthogranulomatous cholecystitis might have relation with cancer, but xanthogranulomatous cholecystitis itself may not be the direct cause for cancer.- - - - - - - - - - ranking = 1.2keywords = gallbladder (Clic here for more details about this article) |
6/25. Xanthogranulomatous cholecystitis resembling carcinoma with extensive tumorous infiltration of the liver and colon.BACKGROUND: Xanthogranulomatous cholecystitis is a macrophage-rich inflammatory condition of the gallbladder that occasionally presents with tumorlike appearance. CASE PRESENTATION: In the present case the inflammation involved all the layers of the gallbladder, the surrounding connective tissue, and part of the right lobe of the liver and right transverse colon. The clinical and radiological findings were suggestive of advanced carcinoma of the gallbladder. However, intraoperative frozen section investigation revealed xanthogranulomatous cholecystitis, for which simple cholecystectomy is the treatment of choice. CONCLUSIONS: The original cause of the condition is unclear in most cases. In the present case it is possible that rupture of the gallbladder in association with the patient's known history of trauma have initiated the process.- - - - - - - - - - ranking = 0.8keywords = gallbladder (Clic here for more details about this article) |
7/25. A case of simultaneous xanthogranulomatous cholecystitis and carcinoma of the gallbladder.Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder. Not only does XGC occasionally present as a mass formation with adjacent organ invasion like a malignant neoplasm, it can also infrequently be associated with gallbladder cancer. In the situation, it is difficult to make a differential diagnosis between the diseases. Here, we describe a case of a simultaneous XGC and a carcinoma of the gallbladder in a 61-year-old woman. To the best of our knowledge, there are only a small number of reports on this combination of diseases.- - - - - - - - - - ranking = 1.4keywords = gallbladder (Clic here for more details about this article) |
8/25. Xanthogranulomatous cholecystitis mimicking stage IV gallbladder cancer.patients with xanthogranulomatous cholecystitis often undergo excessive surgical resections because of difficulty in distinguishing their condition from gallbladder cancer. Herein we present a patient with xanthogranulomatous cholecystitis mimicking stage IVA gallbladder cancer who underwent a hepatopancreatoduodenectomy. The 64-year-old man was admitted to the local hospital with a chief complaint of high fever, hypochondrolgia and jaundice. One month later, he transferred to Tsukuba University Hospital with a hard palpable fixed large tumor in the right hypochondrium. Computed tomography and ultrasonography showed a tumor originating from the gallbladder extending to the adjacent liver parenchyma, as well as nodes in the hepatoduodenal ligaments approaching the head of the pancreas. Endoscopic retrograde cholangiopancreatography failed to exhibit the gallbladder despite the visualization of irregular narrowing of the common hepatic duct. angiography demonstrated encasement of the right hepatic artery and narrowing of the right portal vein. On the other hand, the level of serum carbohydrate antigen 19-9 was within normal range. Based on those findings, a right hepatic lobectomy with pancreaticoduodenectomy was conducted under the preoperative and intraoperative diagnosis of gallbladder cancer; stage IVA. The gross findings of the surgical specimen showed an ill-defined yellowish hard mass, but microscopic examination demonstrated xanthogranulomatous cholecystitis. The presented case shows that xanthogranulomatous cholecystitis can mimic an advanced gallbladder carcinoma when the severe chronic inflammatory changes have extended to the liver hilum down to the head of the pancreas. However, the normal level of tumor markers in all clinical courses might be a reason to consider xanthogranulomatous cholecystitis instead of gallbladder cancer. Even when the correct diagnosis is made, the possibility that the adjacent organs should be resected is not remote.- - - - - - - - - - ranking = 2.2keywords = gallbladder (Clic here for more details about this article) |
9/25. Synchronous granulomatous cholecystitis and fibroelastosis of the gallbladder.We describe an unusual form of xanthogranulomatous cholecystitis in a 69-year-old man, with abundant intramural concrement formation and a local fibroelastosis of the adjacent interstitium and arteries. The gallbladder was obtained following resection of an adenocarcinoma of the gastro-esophageal junction without evidence of metastases. Only two cases of fibroelastosis of the gallbladder have previously been reported, and its pathogenesis is unknown. The influence of bile that leaked into the interstitium or a specific local tissue response to cytokines secreted by histiocytes are among the possible explanations for its development in our case.- - - - - - - - - - ranking = 1.2keywords = gallbladder (Clic here for more details about this article) |
10/25. Xanthogranulomatous inflammation presenting as a submucosal mass of the sigmoid colon.Xanthogranulomatous inflammation (XGI) is a well-recognized disease process in the kidney and gallbladder. However, involvement of the colon is extremely rare. On the other hand, it is important to recognize that clinically and radiologically, XGI could be misinterpreted as an infiltrative cancer. Recently the authors encountered a 38-year-old woman who presented with a submucosal mass-like lesion in the sigmoid colon. Radiological imaging had also suggested a possibility of sigmoid colon cancer as well as pelvic inflammatory disease or actinomycosis. Although XGI may rarely occur in the large bowel, it should be considered in patients with a colonic submucosal mass. In addition, it is important to make an intraoperative pathological diagnosis in order to avoid any excessive operative stress.- - - - - - - - - - ranking = 0.2keywords = gallbladder (Clic here for more details about this article) |
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