Journal of Case Reports and Reviews in Medicine (ISSN: 3069-0749)
Case Report Volume: 2 & Issue: 3
Case Report Volume: 2 & Issue: 3
Xanthogranulomatous cholecystitis (XGC) is an uncommon chronic inflammatory disease of the gallbladder that can closely mimic gallbladder carcinoma on clinical assessment and cross-sectional imaging. We report a 27-year-old man with one month of persistent upper abdominal pain, tenderness, intermittent fever and weight loss. Ultrasonography demonstrated marked circumferential gallbladder wall thickening, with intramural nodular/cystic foci and few ring-down artifacts. No gallstones or pericholecystic fluid were identified. Contrast-enhanced computed tomography showed a contracted gallbladder with diff use wall thickening up to 21 mm, patchy mural enhancement and preserved mucosal enhancement. No radiopaque gallstones, significant pericholecystic fat stranding, biliary dilatation or overt invasive features were present. An inflammatory process was favored because of the patient’s young age and the absence of aggressive imaging features. Open cholecystectomy was performed. Histopathology demonstrated transmural inflammation with bile lakes, macrophages, lymphocytes, plasma cells and extensive bile ductular proliferation without malignancy, confirming XGC. This case highlights that XGC should remain in the differential diagnosis of marked gallbladder wall thickening even in young adults without cholelithiasis. Recognition of intramural nodules and preserved mucosal enhancement can increase preoperative confidence for XGC, although histopathologic confirmation remains essential when malignancy cannot be excluded.
Keywords: Xanthogranulomatous Cholecystitis; Gallbladder Carcinoma; Computed Tomography; Ultrasonography; Gallbladder Wall Thickening.
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