Abstract
A 73-year-old woman with abdominal discomfort demonstrated a stone measuring 2.0cm wall thickness at the gallbladder neck, and a low density tumor located in the liver hilum extending to right intrahepatic glisson's sheath on abdominal CT. The tumor demonstrated low intensity on T1-weighted image and high intensity on not only T2-weighted image, but also diffusion-weighted image of MRI. ERCP demonstrated smooth narrowing of the upper part of the common bile duct and right hepatic duct. Based on these findings, the diagnosis was Mirizzi's syndrome. However, obstructive jaundice developed 25 days after admission. On ERCP and CT, stenosis of the bile duct had become progressive and extended from the upper part of the common bile duct to the left and right intrahepatic duct at the secondary bifurcation. Under the diagnosis of gallbladder carcinoma, right lobectomy including extrahepatic bile duct resection was performed. Microscopically, the mass was composed of marked and dense inflammatory cell infiltration of histiocytes indicating xanthogranulomatous cholecystitis.
