Xanthogranulomatous Cholecystitis Cohort Study: A Clinicopathological And Incidental Frequency Analysis

Abstract

Background: Xanthogranulomatous cholecystitis is a benign, uncommon, localized or diffuse inflammatory pathological condition of the gallbladder and a catastrophic distinct transformation of chronic cholecystitis. Macroscopically distinguished by multiple yellowish with lipid packed tumor like foamy masses (nodules or streaks) in the wall of the gallbladder. Microscopically, it is distinguished by a number of bubbly histiocytes with acute or chronic inflammatory cells, while in upcoming phase manifest with tremendous fibrosis. The present study was undertaken to analysis of the histopathology reports to see the frequency of incidental xanthogranulomatous cholecystitis after elective cholecystectomy. Methods: 1522 cholecystectomies performed from January 2011 to December 2015, at tertiary care single centre Ziauddin University and Hospitals Karachi Pakistan. On Histopathology of ten gallbladder specimens after elective cholecystectomy revealed xanthogranulomatous cholecystitis. These histologically confirmed cases are identified from the retrospective analysis of patient’s record. Results: During the study period 1522 patients underwent cholecystectomy. Histopathologically confirmed xanthogranulomatous cholecystitis in ten patients (0.65% of all cholecystectomies). The mean age and standard deviation of patients with xanthogranulomatous cholecystitis was 54 + 17.19 years (range 29-85), with male to female ratio is 1:1. The most common clinical features were abdominal pain and tenderness in the right hypochondrium. Biliary colic and acute cholecystitis were the most common preoperative diagnostic features. Ultrasonogram was performed in all patients. Conclusion: Xanthogranulomatous cholecystitis is a scarce variant of cholecystitis with marked topographical discrepancy and preoperative clinical uncertainty and a per-operative diagnosis is a challenging task. Many times diagnosis is a histopathological revelation. Key Words: Xanthogranulomatous cholecystitis, Histopathology, Gallstones, Cohort study.