MRI Appearances of Xanthogranulomatous Cholecystitis in 7 Patients_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 GOUWen-xiao ^1,2 ,  YINLong-lin ² , XIEHuan ^1,2 , CHENXiao-yu ² , WANGFu-min ²

1. The medical imaging department, Southwest Medical University, Luzhou 646000, Sichuan Province, China;
2. Department of Radiology, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Sciences, Chengdu 610072, Sichuan Province, China;

Corresponding author：

YINLong-lin, Email: yinlonglin@163.com

Keywords：

Xanthogranulomatous cholecystitis; MRI; Value

DOI：

10.7507/1007-9424.20160094

Video：

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Objective To investigate clinical value of MRI examination in diagnosis of xanthogranulomatous cholecystitis (XGC), and to analyze pathologic correlation of various imaging findings. Methods MRI imaging data of 7 patients with XGC proved by surgery and pathology who underwent entire MRI sequences examination in Sichuan Provincial People's Hospital from Jan. 2013 to Dec. 2015, were analyzed retrospectively. The thickness and contrast enhancement of gallbladder wall, gallbladder wall nodules, completeness of gallbladder mucosa lines, gallbladder stones, and the changes around the gallbladder were focused in every patient. Results In 7 patients with XGC: gallbladder wall thickening occurred in all patients, in which 2 patients were local thickening, 5 patients were diffuse thickening; ‘hypodense band sign' was found by enhance scan in 4 patients; the multiple intramural nodules were presented in 5 patients, which were low signal intensity on T1WI image and high signal intensity on T2WI image; the mucosal lines were continuous in 6 patients and discontinuous in 1 patient; 6 patients combined with cholecystolithiasis. The fat layer around the gallbladder was found fuzz in 7 patients, liver and gallbladder boundaries were not clear in 7 patients; temporal enhancement of arterial phase in liver parenchyma was observed in all patients, and 1 patient combined with liver abscess. Hilar bile duct narrowed and intra-hepatic bile duct dilated in 2 patients, intra-hepatic and extra-hepatic bile duct slightly dilated in 2 patients (lower part of the choledochus stone was found in 1 patient), liver cyst was observed in 3 patients, single or double kidney cyst was observed in 4 patients; all patients were not found intraperitoneal or retroperitoneal swelling lymph nodes. Conclusion MRI examination can accurately describe various imaging features of XGC, so MRI has important value in diagnosis of XGC.

Citation： GOUWen-xiao, YINLong-lin, XIEHuan, CHENXiao-yu, WANGFu-min. MRI Appearances of Xanthogranulomatous Cholecystitis in 7 Patients. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(3): 355-359. doi: 10.7507/1007-9424.20160094 Copy

1.	Guzmán-Valdivia G. Xanthogranulomatous cholecystitis: 15 years' experience. World J Surg, 2004, 28(3): 254-257.
2.	Mccoy JJ, Vila R, Petrossian G, et al. Xanthogranulomatous cholec-ystitis. Report of two cases. J S C Med Assoc, 1976, 72(3): 78-79.
3.	马光慧, 嵇鸣, 叶春涛, 等. 黄色肉芽肿性胆囊炎的MRI特征. 磁共振成像, 2014, 5(4): 283-286.
4.	龚海燕, 戈伟, 蒋松松, 等. 48例黄色肉芽肿性胆囊炎的诊治分析. 中国普外基础与临床杂志, 2014, 21(8): 1009-1012.
5.	Han SH, Chen YL. Diagnosis and treatment of xanthogranuloma-tous cholecystitis: a report of 39 cases. Cell Biochem Biophys, 2012, 64(2): 131-135.
6.	郑渤伟, 李丹. 黄色肉芽肿性胆囊炎223例诊治分析. 中国中西医结合外科杂志, 2015, 21(1): 35-38.
7.	Takahashi K, Oka K, Hakozaki H, et al. Ceroid-like histiocytic granuloma of gall-bladder-a previously undescribed lesion. Acta Pathol Jpn, 1976, 26(1): 25-46.
8.	Singal R, Gupta S, Pande P, et al. Xanthogranulomatous cholecystitis: case series in a rural area, clinicopathological study and review of literature. Acta Gastroenterol Latinoam, 2011, 41(4): 331-334.
9.	王蔚蓝, 孙海明. 黄色肉芽肿性胆囊炎45例诊治分析. 肝胆胰外科杂志, 2015, 27(1): 74-75.
10.	Uchiyama K, Ozawa S, Ueno M, et al. Xanthogranulomatous cholec-ystitis: the use of preoperative CT findings to differentiate it from gallbladder carcinoma. J Hepatobiliary Pancreat Surg, 2009, 16(3): 333-338.
11.	Kwon AH, Matsui Y, Uemura Y. Surgical procedures and histopa-thologic findings for patients with xanthogranulomatous cholecys-titis. J Am Coll Surg, 2004, 199(2): 204-210.
12.	马黎斌, 夏进东, 林江, 等. 黄色肉芽肿性胆囊炎影像学表现及其病理学基础. 临床放射学杂志, 2013, 32(7): 991-995.
13.	李代欣, 朱西琪, 田玉亭, 等. CT及MRI在黄色肉芽肿性胆囊炎诊断中的应用. 生物医学工程与临床, 2015, 19(2): 164-168.
14.	Zhao F, Lu PX, Yan SX, et al. CT and MR features of xanthogranu-lomatous cholecystitis: an analysis of consecutive 49 cases. Eur J Radiol, 2013, 82(9): 1391-1397.
15.	黄子星, 陈光文, 鲁昌立, 等. 黄色肉芽肿性胆囊炎的MRI表现特点. 中国临床医学影像杂志, 2010, 21(12): 856-859.
16.	Yoshimitsu K, Irie H, Aibe H, et al. Well-differentiated adenocar-cinoma of the gallbladder with intratumoral cystic components due to abundant mucin production: a mimicker of adenomyomatosis. Eur Radiol, 2005, 15(2): 229-233.
17.	Agrawal V, Goel A, Krishnani N, et al. p53, carcinoembryonic antigen and carbohydrate antigen 19-9 expression in gall bladder cancer, precursor epithelial lesions and xanthogranulomatous holecystitis. J Postgrad Med, 2010, 56(4): 262-266.
18.	Chun KA, Ha HK, Yu ES, et al. Xanthogranulomatous cholecystitis: CT features with emphasis on differentiation from gallbladder carcinoma. Radiology, 1997, 203(1): 93-97.
19.	Goshima S, Chang S, Wang JH, et al. Xanthogranulomatous cholec-ystitis: diagnostic performance of CT to differentiate from gallbladder cancer. Eur J Radiol, 2010, 74(3): e79-e83.
20.	陈徐艰, 王兢, 沈亦钰, 等. 黄色肉芽肿性胆囊炎79例回顾性研究. 肝胆胰外科杂志, 2013, 25(6): 495-496.
21.	Shuto R, Kiyosue H, Komatsu E, et al. CT and MR imaging findings of xanthogranulomatous cholecystitis: correlation with pathologic findings. Eur Radiol, 2004, 14(3): 440-446.
22.	Ito K, Awaya H, Mitchell DG, et al. Gallbladder disease: appearance of associated transient increased attenuation in the liver at biphasic, contrast-enhanced dynamic CT. Radiology, 1997, 204(3): 723-728.
23.	Guermazi A. Are there other imaging features to differentiate xanthogranulomatous cholecystitis from gallbladder carcinoma?. Eur Radiol, 2005, 15(6): 1271-1272.
24.	吴丽足, 林礼务, 薛恩生, 等. 彩色多普勒超声在黄色肉芽肿性胆囊炎与胆囊癌鉴别诊断中的价值. 中国超声医学杂志, 2013, 29(8): 702-704.
25.	Chang BJ, Kim SH, Park HY, et al. Distinguishing xanthogranuloma-tous cholecystitis from the wall-thickening type of early-stage gallb-ladder cancer. Gut Liver, 2010, 4(4): 518-523.

1. Guzmán-Valdivia G. Xanthogranulomatous cholecystitis: 15 years' experience. World J Surg, 2004, 28(3): 254-257.
2. Mccoy JJ, Vila R, Petrossian G, et al. Xanthogranulomatous cholec-ystitis. Report of two cases. J S C Med Assoc, 1976, 72(3): 78-79.
3. 马光慧, 嵇鸣, 叶春涛, 等. 黄色肉芽肿性胆囊炎的MRI特征. 磁共振成像, 2014, 5(4): 283-286.
4. 龚海燕, 戈伟, 蒋松松, 等. 48例黄色肉芽肿性胆囊炎的诊治分析. 中国普外基础与临床杂志, 2014, 21(8): 1009-1012.
5. Han SH, Chen YL. Diagnosis and treatment of xanthogranuloma-tous cholecystitis: a report of 39 cases. Cell Biochem Biophys, 2012, 64(2): 131-135.
6. 郑渤伟, 李丹. 黄色肉芽肿性胆囊炎223例诊治分析. 中国中西医结合外科杂志, 2015, 21(1): 35-38.
7. Takahashi K, Oka K, Hakozaki H, et al. Ceroid-like histiocytic granuloma of gall-bladder-a previously undescribed lesion. Acta Pathol Jpn, 1976, 26(1): 25-46.
8. Singal R, Gupta S, Pande P, et al. Xanthogranulomatous cholecystitis: case series in a rural area, clinicopathological study and review of literature. Acta Gastroenterol Latinoam, 2011, 41(4): 331-334.
9. 王蔚蓝, 孙海明. 黄色肉芽肿性胆囊炎45例诊治分析. 肝胆胰外科杂志, 2015, 27(1): 74-75.
10. Uchiyama K, Ozawa S, Ueno M, et al. Xanthogranulomatous cholec-ystitis: the use of preoperative CT findings to differentiate it from gallbladder carcinoma. J Hepatobiliary Pancreat Surg, 2009, 16(3): 333-338.
11. Kwon AH, Matsui Y, Uemura Y. Surgical procedures and histopa-thologic findings for patients with xanthogranulomatous cholecys-titis. J Am Coll Surg, 2004, 199(2): 204-210.
12. 马黎斌, 夏进东, 林江, 等. 黄色肉芽肿性胆囊炎影像学表现及其病理学基础. 临床放射学杂志, 2013, 32(7): 991-995.
13. 李代欣, 朱西琪, 田玉亭, 等. CT及MRI在黄色肉芽肿性胆囊炎诊断中的应用. 生物医学工程与临床, 2015, 19(2): 164-168.
14. Zhao F, Lu PX, Yan SX, et al. CT and MR features of xanthogranu-lomatous cholecystitis: an analysis of consecutive 49 cases. Eur J Radiol, 2013, 82(9): 1391-1397.
15. 黄子星, 陈光文, 鲁昌立, 等. 黄色肉芽肿性胆囊炎的MRI表现特点. 中国临床医学影像杂志, 2010, 21(12): 856-859.
16. Yoshimitsu K, Irie H, Aibe H, et al. Well-differentiated adenocar-cinoma of the gallbladder with intratumoral cystic components due to abundant mucin production: a mimicker of adenomyomatosis. Eur Radiol, 2005, 15(2): 229-233.
17. Agrawal V, Goel A, Krishnani N, et al. p53, carcinoembryonic antigen and carbohydrate antigen 19-9 expression in gall bladder cancer, precursor epithelial lesions and xanthogranulomatous holecystitis. J Postgrad Med, 2010, 56(4): 262-266.
18. Chun KA, Ha HK, Yu ES, et al. Xanthogranulomatous cholecystitis: CT features with emphasis on differentiation from gallbladder carcinoma. Radiology, 1997, 203(1): 93-97.
19. Goshima S, Chang S, Wang JH, et al. Xanthogranulomatous cholec-ystitis: diagnostic performance of CT to differentiate from gallbladder cancer. Eur J Radiol, 2010, 74(3): e79-e83.
20. 陈徐艰, 王兢, 沈亦钰, 等. 黄色肉芽肿性胆囊炎79例回顾性研究. 肝胆胰外科杂志, 2013, 25(6): 495-496.
21. Shuto R, Kiyosue H, Komatsu E, et al. CT and MR imaging findings of xanthogranulomatous cholecystitis: correlation with pathologic findings. Eur Radiol, 2004, 14(3): 440-446.
22. Ito K, Awaya H, Mitchell DG, et al. Gallbladder disease: appearance of associated transient increased attenuation in the liver at biphasic, contrast-enhanced dynamic CT. Radiology, 1997, 204(3): 723-728.
23. Guermazi A. Are there other imaging features to differentiate xanthogranulomatous cholecystitis from gallbladder carcinoma?. Eur Radiol, 2005, 15(6): 1271-1272.
24. 吴丽足, 林礼务, 薛恩生, 等. 彩色多普勒超声在黄色肉芽肿性胆囊炎与胆囊癌鉴别诊断中的价值. 中国超声医学杂志, 2013, 29(8): 702-704.
25. Chang BJ, Kim SH, Park HY, et al. Distinguishing xanthogranuloma-tous cholecystitis from the wall-thickening type of early-stage gallb-ladder cancer. Gut Liver, 2010, 4(4): 518-523.

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MRI Appearances of Xanthogranulomatous Cholecystitis in 7 Patients

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