Xanthogranulomatous Cholecystitis Masquerading as Gallbladder Cancer: Can It Be Diagnosed Preoperatively?

Background. Xanthogranulomatous cholecystitis (XGC) is often misdiagnosed as gallbladder cancer (GBC). We aimed to determine the preoperative characteristics that could potentially aid in an accurate diagnosis of XGC masquerading as GBC. Methods. An analysis of patients operated upon with a preopera...

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Bibliographic Details
Published in:Gastroenterology research and practice 2014-01, Vol.2014 (2014), p.1-5
Main Authors: Palaniappan, Ravichandran, Sathyanesan, Jeswanth, Cherukuri, Sathya D., Rammohan, Ashwin, Govindan, Manoharan
Format: Article
Language:English
Subjects:
Algorithms
Biomarkers
Cholecystectomy
Cholecystitis
Diagnosis
Disease
Gallbladder
Gallbladder cancer
Gallbladder diseases
Histopathology
Laparoscopy
Lymphatic system
Medical errors
Medical research
Medicine, Experimental
Morbidity
Mortality
Patients
Prevention
Surgery
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Summary:Background. Xanthogranulomatous cholecystitis (XGC) is often misdiagnosed as gallbladder cancer (GBC). We aimed to determine the preoperative characteristics that could potentially aid in an accurate diagnosis of XGC masquerading as GBC. Methods. An analysis of patients operated upon with a preoperative diagnosis of GBC between January 2008 and December 2012 was conducted to determine the clinical and radiological features which could assist in a preoperative diagnosis of XGC. Results. Out of 77 patients who underwent radical cholecystectomy, 16 were reported as XGC on final histopathology (Group A), while 60 were GBC (Group B). The incidences of abdominal pain, cholelithiasis, choledocholithiasis, and acute cholecystitis were significantly higher in Group A, while anorexia and weight loss were higher in Group B. On CT, diffuse gallbladder wall thickening, continuous mucosal line enhancement, and submucosal hypoattenuated nodules were significant findings in Group A. CT findings on retrospect revealed at least one of these findings in 68.7% of the cases. Conclusion. Differentiating XGC from GBC is difficult, and a definitive diagnosis still necessitates a histopathological examination. An accurate preoperative diagnosis requires an integrated review of clinical and characteristic radiological features, the presence of which may help avoid radical resection and avoidable morbidity in selected cases.
ISSN:1687-6121
1687-630X
DOI:10.1155/2014/253645