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Journal of Medical Ultrasonics

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2002 - Vol.29

Vol.29 No.03

Case Report(症例報告)

(J263 - J268)


Fifteen Cases of Xanthogranulomatous Cholecystitis: Ultrasonographic Findings

横田 重樹1, 岡 博子2, 大内田 祐一1, 櫻田 啓子1, 嶋 三恵子1, 中井 隆志2, 川崎 靖子2, 根引 浩子2, 堀井 勝彦3, 松山 光春3, 山崎 修3, 井上 健4

Shigeki YOKOTA1, Hiroko OKA2, Yuichi OUCHIDA1, Keiko SAKURADA1, Mieko SHIMA1, Takashi NAKAI2, Yasuko KAWASAKI2, Hiroko NEBIKI2, Katsuhiko HORII3, Mitsuharu MATSUYAMA3, Osamu YAMAZAKI3, Takeshi INOUE4

1大阪市立総合医療センター中央臨床検査部, 2大阪市立総合医療センター消化器内科, 3大阪市立総合医療センター消化器外科, 4大阪市立総合医療センター病理部

1Central Clinical Laboratory, Osaka City General Hospital, 2Department of Gastroenterology, Osaka City General Hospital, 3Department of Surgery, Osaka City General Hospital, 4Department of Pathology, Osaka City General Hospital

キーワード : cholecystitis, cholelithiasis, ultrasonography, CA 19-9

We studied 15 cases of xanthogranulomatous cholecystitis (XGC) that were diagnosed from 633 specimens of gallbladder after cholecystectomy performed from January 1994 to June 2000. Preoparative ultrasonographic diagnoses of these cases were as follows: gallbladder cancer in 8 patients, gallstones in 5, and cholecystitis in 2. Patients were aged 54 to 83 year-old. The main symptoms were abdominal pain in 11 cases and high fever in 9 cases. Additionally, 13 cases were positive for CRP; leucocytosis exceeded 10 000 /mm3 in 5 cases; and serum CA 19-9 level was greater than 2000 IU/ml in 2 cases. Gallbladder wall thickness ranged from 2 to 15 mm, and ultrasonography showed gallstones in 14 cases. Although the characteristic ultrasonographic findings of XGC in previous reports included irregular wall thickening and hyperehoic lesions in the wall, wall thickening was not always present in the cases discussed here.