Zhang Jinchang, Lin Haomin, Li Xujia, Wang Piao, Yang Xiaoli, Li Bo, Guo Qinxi, Su Song
Department of General Surgery (Hepatobiliary Surgery), The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Front Oncol. 2023 May 16;13:1191181. doi: 10.3389/fonc.2023.1191181. eCollection 2023.
Xanthogranulomatous inflammation (XGI) is a rare, benign condition that can affect several organs, including the gallbladder, kidney, skin, gastrointestinal tract, lymph nodes, and soft tissues. It is often misdiagnosed as a malignancy. In this report, we present the case of a 79-year-old male who presented with persistent jaundice for 11 months. Computed tomography and magnetic resonance imaging revealed pancreatic head enlargement, gallbladder thickening, and common bile duct thickening, leading to a preoperative diagnosis of malignant neoplasm of the pancreatic head. During surgery, dense adhesions were found around the portal vein, suggestive of mass invasion. To relieve obstruction, choledochojejunostomy was performed. Postoperative pathological examination revealed xanthogranulomatous cholecystitis (XGCc), xanthogranulomatous cholangitis (XGCg), and xanthogranulomatous pancreatitis (XGP). XGI affecting the bile ducts and pancreas is extremely rare, and there are no reported cases of simultaneous involvement of the gallbladder, bile duct, and pancreas by XGI. This study provides valuable insight into the differential diagnosis of XGI by presenting the imaging features of XGI patients.
黄色肉芽肿性炎症(XGI)是一种罕见的良性病症,可累及多个器官,包括胆囊、肾脏、皮肤、胃肠道、淋巴结和软组织。它常被误诊为恶性肿瘤。在本报告中,我们介绍了一例79岁男性患者,其持续性黄疸达11个月。计算机断层扫描和磁共振成像显示胰头增大、胆囊增厚和胆总管增厚,术前诊断为胰头恶性肿瘤。手术中发现门静脉周围有致密粘连,提示有肿块侵犯。为缓解梗阻,进行了胆总管空肠吻合术。术后病理检查显示为黄色肉芽肿性胆囊炎(XGCc)、黄色肉芽肿性胆管炎(XGCg)和黄色肉芽肿性胰腺炎(XGP)。XGI累及胆管和胰腺极为罕见,且尚无XGI同时累及胆囊、胆管和胰腺的报道病例。本研究通过呈现XGI患者的影像学特征,为XGI的鉴别诊断提供了有价值的见解。