Kitagawa S, Nakagawa M, Yamada T, Mori Y, Simizu H, Rin S, Kurumaya H
Department of Gastrointestinal Surgery, Radiology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
Nihon Geka Gakkai Zasshi. 1990 Aug;91(8):1001-10.
Xanthogranulomatous cholecystitis (XGC) is an uncommon lesion which may form a tumor-like mass in inflamed gallbladders. In a review of 44 cases there were 40 associated with gallstones which had been incarcerated in the neck of the gallbladder, 10 with past histories of abdominal surgeries, 15 with diabetes mellitus, three with carcinomas in the neck of the gallbladder and four with carcinomas in the other organs. Radiologically the differential diagnosis of gallbladder cancer and XGC was difficult in several cases. Thirty five cases of XGC have been diagnosed as chronic cholecystitis and 7 have been mistaken for feature of XGC in the contrast enhancement CT that is, detection of an intramural low density mass with continuously enhanced internal membraneous layer of the gallbladder wall. In view of the clinico-pathological findings of XGC, the lesions appear to result from intramural extravasation of bile and subsequent xanthogranulomatous reaction under obstructive conditions in the neck of the gallbladder. We conclude that XGC is not an uncommon special type of cholecystitis but an accompanied lesion sometimes seen in a kind of cholecystitis.
黄色肉芽肿性胆囊炎（XGC）是一种罕见的病变，可在发炎的胆囊中形成肿瘤样肿块。在对44例病例的回顾中，有40例与嵌顿在胆囊颈部的胆结石相关，10例有腹部手术史，15例患有糖尿病，3例胆囊颈部有癌，4例其他器官有癌。在放射学上，胆囊癌与XGC的鉴别诊断在一些病例中很困难。35例XGC被诊断为慢性胆囊炎，7例在对比增强CT中因XGC特征被误诊，即检测到胆囊壁内低密度肿块且胆囊壁内膜层持续强化。鉴于XGC的临床病理表现，这些病变似乎是由于胆囊颈部梗阻情况下胆汁壁内外渗及随后的黄色肉芽肿反应所致。我们得出结论，XGC不是一种罕见的特殊类型胆囊炎，而是一种有时在某种胆囊炎中出现的伴随病变。
