Eriguchi N, Aoyagi S, Tamae T, Kanazawa N, Nagashima J, Nishimura K, Hamada S, Kawabata M, Kodama T
Department of Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan.
Kurume Med J. 2001;48(3):219-21. doi: 10.2739/kurumemedj.48.219.
Seven cases of xanthogranulomatous cholecystitis are presented, and their clinicopathological appearance is described. Three men and 4 women with xanthogranulomatous cholecystitis, aged 53-72 years old, were reviewed. Five patients had had previous attacks of acute cholecystitis lasting from 3 weeks to 6 months. Abdominal ultrasonography was performed in all patients, and computed tomography in 5 patients. Cholelithiasis and sludge were present in all patients. The gallbladder wall was thickened in all patients. On computed tomography, one patient showed no abnormal finding, and 4 patients had abnormal findings such as increased wall thickness and irregularity, and pericholecystic abnormalities. A diagnosis of gallbladder carcinoma was made preoperatively in 1 patient. During laparotomy, the gallbladders in all patients showed signs of chronic cholecystitis, and cholecystectomies were performed. Histological findings showed xanthogranulomatous cholecystitis, and 4 patients had stones in the gallbladder wall. Despite the characteristic histologic appearance of xanthogranulomatous cholecystitis, radiologic findings are nonspecific, varying from signs observed in other forms of cholecystitis to the appearance of a gallbladder neoplasm. We report here 7 cases of xanthogranulomatous cholecystitis and review the literature.
本文报告7例黄色肉芽肿性胆囊炎,并描述其临床病理表现。回顾了3例男性和4例女性黄色肉芽肿性胆囊炎患者,年龄在53 - 72岁之间。5例患者既往有持续3周至6个月的急性胆囊炎发作史。所有患者均行腹部超声检查,5例患者行计算机断层扫描(CT)检查。所有患者均存在胆石症和胆泥。所有患者胆囊壁均增厚。CT检查中,1例患者未见异常,4例患者有异常表现,如胆囊壁增厚、不规则以及胆囊周围异常。术前1例患者被诊断为胆囊癌。剖腹手术中,所有患者的胆囊均显示慢性胆囊炎征象,并进行了胆囊切除术。组织学检查结果显示为黄色肉芽肿性胆囊炎,4例患者胆囊壁有结石。尽管黄色肉芽肿性胆囊炎具有特征性的组织学表现,但其影像学表现不具有特异性,从其他形式胆囊炎的表现到胆囊肿瘤的表现不等。我们在此报告7例黄色肉芽肿性胆囊炎并复习相关文献。