Abstract
An examination for FDG-PET is useful for the differentiation of the malignant tumor of biliary tract origin, but may often have a hard time for a diagnosis. A 60-year-old woman admitted to the hospital because of right hypochondralgia and became this course introduction after conservative treatment by a diagnosis of the acute cholecystitis. An abdominal US and CT revealed an irregular wall thickening with the high-speed bloodstream in the gallbladder body and fundus and the swelling of the lymph nodes in a hepatic portal region and paraaorta. FDG-PET showed a high accumulation of FDG in both of them, so we made a diagnosis of gallbladder cancer with lymph node metastasis. Laparotomy was performed, and the lymph node of paraaorta was revealed to be a tuberculous lymphadenitis by intraoperative frozen-section examination. Extended cholecystectomy and extrahepatic bile duct resection had been done, and the histopathologic final diagnosis was given as a result of xanthogranulomatous cholecystitis and tuberculous lymphadenitis. When FDG accumulation in gallbladder and the regional lymph node, I thought about the gallbladder malignancy with lymph node metastases to the first, but it was thought that an inflammatory disease had to take the coexistent possibility into consideration.
