A Case of Xanthogranulomatous Cholecystitis with Difficulty in Preoperative Diagnosis
1)Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University
2)Department of Diagnostic Pathology, Saitama Medical Center, Saitama Medical University
A 72-year-old woman was referred to our hospital with jaundice, right hypochondrial pain, and fever. Enhanced computed tomography revealed a greatly thickened gallbladder wall, a large gallstone (Φ33 mm), and encasement of the right hepatic artery. Percutaneous transhepatic cholangiography revealed severe stenosis extending from the hilar bifurcation of the bile ducts to the common bile duct. Pathological examination of the gallbladder wall during surgery for gallstone ileus carried out 4 days after percutaneous transhepatic portal vein embolization led to a final diagnosis of xanthogranulomatous cholecystitis. Physicians need to be alert to the possibility of xanthogranulomatous cholecystitis, which is difficult to differentiate from advanced gallbladder cancer.
日医大医会誌 2012; 8(2), 157-161
xanthogranulomatous cholecystitis, gallbladder cancer, percutaneous transhepatic portal vein embolization, gallstone ileus
Takashi Ishida, Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan