Rastogi Archana, Singh Deepak Kumar, Sakhuja Puja, Gondal Ranjana
Department of Pathology, G B Pant Hospital, New Delhi 110 002, India.
Indian J Pathol Microbiol. 2010 Jan-Mar;53(1):144-7. doi: 10.4103/0377-4929.59209.
Xanthogranulomatous inflammation of gallbladder wall can extend and infiltrate adjacent organs which can be mistaken for malignancy on preoperative investigations and, intraoperatively, often leads to extensive surgical resections. Only the histopathologic examination of the specimen allows correct diagnosis. We hereby review clinicopathologic findings of six cases which underwent extensive surgeries on clinical, radiological and intraoperative suspicion of gallbladder carcinoma which turned out to be xanthogranulomatous cholecystitis (XGC). There was no evidence of malignancy on histopathologic examination. Xanthogranulomatous inflammation extended into liver, duodenum, colon and stomach in case 1; liver and colon in case 2; liver, duodenum, colon in case 3; stomach, duodenum, colon in case 4; stomach and duodenum in case 5 and duodenum and colon in case 6. Lymph nodes in all the six cases showed reactive hyperplasia. We present here the clinico-radiologic findings of these cases, techniques which may help differentiate between an XGC and a gallbladder carcinoma and also discuss the management of these cases.
胆囊壁的黄色肉芽肿性炎症可蔓延并浸润邻近器官,这在术前检查时可能被误诊为恶性肿瘤,在术中则常导致广泛的手术切除。只有对标本进行组织病理学检查才能做出正确诊断。我们在此回顾6例因临床、影像学和术中怀疑为胆囊癌而接受广泛手术的病例的临床病理结果,结果显示为黄色肉芽肿性胆囊炎(XGC)。组织病理学检查未发现恶性证据。病例1中黄色肉芽肿性炎症蔓延至肝脏、十二指肠、结肠和胃;病例2中蔓延至肝脏和结肠;病例3中蔓延至肝脏、十二指肠、结肠;病例4中蔓延至胃、十二指肠、结肠;病例5中蔓延至胃和十二指肠;病例6中蔓延至十二指肠和结肠。所有6例病例的淋巴结均显示反应性增生。我们在此展示这些病例的临床放射学结果、有助于鉴别XGC和胆囊癌的技术,并讨论这些病例的处理方法。