Novosti
Khirurgii

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Year 2023 Vol. 31 No 1

SCIENTIFIC PUBLICATIONS

S.I. PIMANOV 1, I.A. LIUTSKO 2, S.V. MALASHENKA 3, K.V. MOSKALEV 1, SAKR ALI 1, P.P. LAKISAU 3, V.A. DUBNIAK 1

XANTHOGRANULOMATOUS CHOLECYSTITIS: A RARE DISEASE WITH ATYPICAL ASSYMPTOM COURSE

Vitebsk State Medical University 1,
Vitebsk Regional Clinical Hospital 2,
Vitebsk Regional Clinical Pathological Bureau 3, Vitebsk,
Republic of Belarus

Xanthogranulomatous cholecystitis is a rare form of inflammation of the gallbladder, the characteristic morphological feature of which is thickening of the wall, its focal or diffuse destructive inflammatory process, followed by pronounced proliferative fibrosis, infiltration by macrophages, giant multinucleated and foamy cells, and xanthomas or ceroid cells are ultimately formed granulomas. The purpose of this work was to demonstrate the diagnosis and surgical treatment of a rare variant of gallbladder disease – xanthogranulomatous cholecystitis – in its atypical asymptomatic clinical course. A case of xanthogranulomatous cholecystitis is described. A 75-year-old patient was admitted in a planned manner for surgical treatment of a recurrence of an inguinal-scrotal hernia on the right. According to complaints, anamnesis and objective examination, there were no signs of gallbladder diseases. There were no pathological changes in the general blood test. An ultrasound examination revealed a pronounced thickening of the gallbladder wall and calculi in its cavity, as well as the presence of areas of reduced echogenicity in the gallbladder wall. Calculi were determined in the cavity of the gallbladder; the wall of the gallbladder was markedly thickened with the presence of areas of reduced echogenicity. There was no blood flow in the bladder wall according to color Doppler mapping. According to the results of computed tomography, thickening of the bladder wall was also recorded; however, it was not possible to make a differential diagnosis of xanthogranulomatous cholecystitis and gallbladder cancer. After cholecystectomy, an unexpected morphological finding was the presence of a pronounced inflammatory process with necrosis of the mucous membrane of the gallbladder wall. Probably, in rare cases, xanthogranulomatous cholecystitis with acute inflammation may be oligosymptomatic or asymptomatic.

Keywords: xanthogranulomatous cholecystitis, acute cholecystitis, ultrasound diagnostics, gallbladder, xanthoma, ceroid
p. 39-47 of the original issue
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Address for correspondence:
210009, Republic of Belarus,
Vitebsk, Frunze Ave., 27,
Vitebsk State Medical University,
Department of Internal Medicine and Ultrasound Diagnostics of the FPC and PC,
e-mail: pimanovs@tut.by,
tel.: +375298996852, +375296857177,
Pimanov Sergei I.
Information about the authors:
Pimanov Sergey I., MD, Professor, Head of the Department of Internal Diseases and Ultrasound Diagnostics, Faculty of Advanced Training and Retraining of Personnel, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-6067-3600
Lyutsko Igor A., Surgeon, Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0003-4580-7038
Malashenko Sergey V. Head of Vitebsk Regional Clinical Pathological and Anatomical Bureau, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-5448-6179
Moskalev Konstantin V. Associate Professor of the Department of Hospital Surgery with the Course of FPC and PC, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-8626-0249
Saqr Ali, Resident of the Department of Hospital Surgery with the Course of FPC and PC of Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0002-2142-9581
Lakisov Pavel P., Head of the Pathoanatomical Department of General Pathology of Vitebsk Regional Clinical Pathological Bureau, Vitebsk, Republic of Belarus.
Dubnyak Victoria A., Student-Subordinator of the Department of Hospital Surgery with the Course of FPC and PC, Vitebsk State Medical University, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
https://orcid.org/0000-0001-5735-0093
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