US FINDINGS OF XANTHOGRANULOMATOUS CHOLECYSTITIS

The ultrasound (US) scans of eleven patients with histologically prove n xanthogranulomatous cholecystitis have been reviewed. The thickness of the gallbladder (GB) wall, echogenicity of the thickened GB mall, t he presence of intramural nodules, gallstones, pericholecystic fluid, loss of wall definition with the liver, and intrahepatic ductal dilata tion were specifically assessed by two radiologists, The range of thic kness of the GB wall was 3-20 mm (mean, 11.2 mm). Thickening was diffu se in nine Eases and focal in two. The thickened GB wall, excluding in tramural nodules, was echogenic in seven, isoechoic in three and hypoe choic in one, compared with hepatic echogenicity. Intramural nodules w ere found in eight cases, These mere discrete, oval or flat, and of lo w echogenicity. These ranged in size from 6 to 12 mm (mean, 10.5 mm). Gallstones were present in six cases and there was intrahepatic duct d ilatation in two of these. Definition between the liver and the GB was obliterated in seven cases. One case of GB perforation, confirmed at operation, demonstrated pre-operatively a GB mall defect and connectio n with the surrounding pericholecystic fluid, Pericholecystic fluid ma s absent in the other 10 cases, Xanthogranulomatous cholecystitis pres ents ultrasonically as GB wall thickening, and the majority of cases i n this series also demonstrated intramural hypoechoic nodules. These f indings can bu helpful in the diagnosis of xanthogranulomatous cholecy stitis.