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.	馬光慧, 嵇鳴, 葉春濤, 等. 黃色肉芽腫性膽囊炎的MRI特征. 磁共振成像, 2014, 5(4): 283-286.
4.	龔海燕, 戈偉, 蔣松松, 等. 48例黃色肉芽腫性膽囊炎的診治分析. 中國普外基礎與臨床雜志, 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.	鄭渤偉, 李丹. 黃色肉芽腫性膽囊炎223例診治分析. 中國中西醫結合外科雜志, 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.	王蔚藍, 孫海明. 黃色肉芽腫性膽囊炎45例診治分析. 肝膽胰外科雜志, 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.	馬黎斌, 夏進東, 林江, 等. 黃色肉芽腫性膽囊炎影像學表現及其病理學基礎. 臨床放射學雜志, 2013, 32(7): 991-995.
13.	李代欣, 朱西琪, 田玉亭, 等. CT及MRI在黃色肉芽腫性膽囊炎診斷中的應用. 生物醫學工程與臨床, 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.	黃子星, 陳光文, 魯昌立, 等. 黃色肉芽腫性膽囊炎的MRI表現特點. 中國臨床醫學影像雜志, 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.	陳徐艱, 王兢, 沈亦鈺, 等. 黃色肉芽腫性膽囊炎79例回顧性研究. 肝膽胰外科雜志, 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.	吳麗足, 林禮務, 薛恩生, 等. 彩色多普勒超聲在黃色肉芽腫性膽囊炎與膽囊癌鑒別診斷中的價值. 中國超聲醫學雜志, 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. 馬光慧, 嵇鳴, 葉春濤, 等. 黃色肉芽腫性膽囊炎的MRI特征. 磁共振成像, 2014, 5(4): 283-286.
4. 龔海燕, 戈偉, 蔣松松, 等. 48例黃色肉芽腫性膽囊炎的診治分析. 中國普外基礎與臨床雜志, 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. 鄭渤偉, 李丹. 黃色肉芽腫性膽囊炎223例診治分析. 中國中西醫結合外科雜志, 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. 王蔚藍, 孫海明. 黃色肉芽腫性膽囊炎45例診治分析. 肝膽胰外科雜志, 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. 馬黎斌, 夏進東, 林江, 等. 黃色肉芽腫性膽囊炎影像學表現及其病理學基礎. 臨床放射學雜志, 2013, 32(7): 991-995.
13. 李代欣, 朱西琪, 田玉亭, 等. CT及MRI在黃色肉芽腫性膽囊炎診斷中的應用. 生物醫學工程與臨床, 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. 黃子星, 陳光文, 魯昌立, 等. 黃色肉芽腫性膽囊炎的MRI表現特點. 中國臨床醫學影像雜志, 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. 陳徐艱, 王兢, 沈亦鈺, 等. 黃色肉芽腫性膽囊炎79例回顧性研究. 肝膽胰外科雜志, 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. 吳麗足, 林禮務, 薛恩生, 等. 彩色多普勒超聲在黃色肉芽腫性膽囊炎與膽囊癌鑒別診斷中的價值. 中國超聲醫學雜志, 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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