Xanthogranulomatous cholecystitis - Mimicking carcinoma gall bladder

Abstract

Xanthogranulomatous cholecystitis (XGC)- a rare pathological entity of gall bladder, is characterized by marked inflammatory infiltrates of macrophages and foam cells with proliferative fibrosis of the gall bladder wall. Although it is a benign condition, its radiological picture and intra operative findings mimic gall bladder carcinoma- leading to misdiagnosis in most cases. We report a case of XGC in a middle-aged lady who presented with a lump in right hypochondrium. Computed Tomography (CT) scans of the abdomen was inconclusive for her. A CT-guided Fine Needle Aspiration Cytology (FNAC) was obtained, where findings were suggestive of XGC which was finally confirmed on histopathological examination of the cholecystectomy specimen. The characteristic cytologic features of XGC on FNAC in this case helped differentiate it from malignancy, thereby sparing the patient a morbid radical surgery. Preoperative FNAC and intraoperative frozen section are valuable tools for differential diagnosis of XGC and help guide the surgeon towards a correct surgical approach.