Xanthogranulomatous Cholecystitis
Laura Webb Lamps, MD
Key Facts
Terminology
Variant of chronic cholecystitis characterized by granulomatous reaction to bile
Macroscopic Features
Cream to brown tumor-like masses, nodules, or plaques
Usually intramural
Gallbladder wall often markedly thickened (up to 2 cm)
Microscopic Pathology
Spectrum of granulomatous lesions centered on ruptured Rokitansky-Aschoff sinuses
Range of lesions from foamy histiocytes to granulomas
Associated ceroid pigment, bile, cholesterol clefts
Pools of extravasated bile may be present in wall of gallbladder
 Xanthogranulomatous cholecystitis often features a markedly thickened wall with overlying mucosal ulceration. Note the associated cholesterol clefts  in the granulomatous inflammation. |
 Xanthogranulomatous cholecystitis is often characterized by a dense infiltrate of foamy histiocytes, many of which contain ceroid pigment. Multinucleated giant cells are also common  . |
TERMINOLOGY
Abbreviations
Xanthogranulomatous cholecystitis (XGC)
Synonyms
Cholegranulomas
Ceroid granulomas
Definitions
Variant of chronic cholecystitis featuring florid proliferation of foamy macrophages and granulomatous reaction to bile
ETIOLOGY/PATHOGENESIS
