Abstract
We report a case of xanthogranulomatous cholecystitis (XGC) that was able to observe an image change with time. A man in his 60's was referred to our department for surgery for gallstones with cholecystitis after conservative treatment. At onset, abdominal CT showed an enlarged gallbladder with cholecystolithiasis at the gallbladder neck. The gallbladder wall was thickened and widespread low-density intramural lesions were present. The mucosal layer had almost uniform contrast. The gallbladder size gradually decreased and the intramural lesions became small. However, the gallbladder wall thickened irregularly and part of the border between the wall and liver parenchyma became unclear. The body and fundus of the wall showed papillaries elevated towards the lumen and the contrast of the mucosal layer became unclear. Cholecystectomy with resection of gallbladder bed was performed under a diagnosis of advanced gallbladder cancer or cholecystitis. The histopathological diagnosis was XGC. This case suggests that low-density lesions in a thickened gallbladder wall and uniform contrast of the mucosal layer are important early findings that suggest XGC.
