黄色肉芽肿性胆囊炎32例临床病理分析

Clinicopathological Study of 32 Cases of Patients with Xanthogranulomatous Cholecystitis

目的探讨黄色肉芽肿性胆囊炎(XGC)临床病理特点。方法对1 426例腹腔镜切除胆囊标本中,经病理确诊的32例XGC结合文献做回顾性分析。结果32例XGC临床表现缺乏特异性。大体观察胆囊壁不同程度增厚,切面常见淡黄色大小不等的结节或斑块,有的有蒂呈息肉样隆起。镜下见胆囊壁的正常结构受到破坏,代之以特征性黄色肉芽肿性结构,由大量泡沫样细胞、急慢性炎细胞、成纤维细胞、异物巨细胞及Touton细胞等组成。结论XGC是一种良性而有破坏性的特殊类型胆囊炎,临床诊断困难,确诊有赖于病理诊断。

Objective To explore the pathological features of Xanthogranulomatous Cholecystitis（XGC）.Methods Among Gallbladders 1426 cases of patients resected by peritoneoscope as specimens,32 XGC that have been diagnosed through pathology were analyzed retrospectively with literature.Results Clinical presentation of 32 XGC lacks specificity.Varying degrees of thickening in gallbladder wall and Straw-colored or brown-yellow plaque or node in cross-section can be seen,some with pedicle swelling like polypus,normal structure of gallbladder wall is found to have bean damadged microscopically,replaced by characteristic yellow granulomatous structure,consisting of plenty of foamy cells,acute and chronic inflammatory cells,fibroblasts,foreign-body giant cells and Touton cells.Conclusion XGC is a special kind of beneign and destructive cholecystitis,Clinical diagnosis is difficult and depends on pathology.