XANTHOGRANULOMATOUS CHOLECYSTITIS - A RADIOLOGICAL STUDY OF 12 CASES AND A REVIEW OF THE LITERATURE

Background: Twelve cases of xanthogranulomatous cholecystitis (XGC) ar e presented, and their radiologic appearance is described. Methods. Fo ur men and eight women, aged 31-82 years old, with XGC were reviewed. Abdominal ultrasound (US) was performed in all patients. Computed tomo graphy (CT) was performed in five patients, barium enema examination i n two, and percutaneously CT-guided fine-needle aspirative biopsy of t he gallbladder in one. Results: Barium enema examination showed an ind entation of the hepatic flexure. Cholelithiasis was present in all pat ients, and sludge was present in six. The gallbladder wall was thicken ed in all patients, irregular in nine, and could not be properly diffe rentiated from surrounding liver parenchyma or from other adjacent str uctures in most patients. A curvilinear halo, hypoechoic on US and wit h low attenuation on CT, within the gallbladder wall was found in thre e patients and pericholecystic fluid in two others, On CT, the pericho lecystic fat had streaky soft tissue densities in three cases, Per cut aneously CT-guided fine-needle aspirative biopsy of the gallbladder wa s nondiagnostic. The diagnosis of gallbladder carcinoma was considered preoperatively In three patients. Conclusion: Despite the characteris tic histologic appearance of XCG, radiologic findings are nonspecific, varying from signs observed in other forms of cholecystitis to the ap pearance of a gallbladder neoplasm.