Male patient, 65 years, presenting with vague right hypochondrial pain. On USG showing marked diffuse thickening of gall bladder wall, measuring up to 20mm maximum thickness. Increased vascularity is also noted within the thickened GB wall.
GB lumen showed a large 20.5mm x 18.6mm calculus, with associated luminal sludge.
Above image showing marked thickening of GB wall on left and ill-defined interface of thickened GB wall with hepatic parenchyma (segment V).
A radiologist in his / her report if can suggest the histopathological diagnosis, I believe that would be an ideal situation. Its never easy even with history, clinical diagnosis, lab tests. The ill-defined margins of thickened GB wall and hepatic parenchyma, was suspicious of infiltration. CA-19-9 value was not available at the time of scan. CECT Abdomen was also performed without much significant added information. There were no significant lymphadenopathy / other focal liver lesions / ascites. Close differentials of XGC and Ca.GB were given. Patient underwent surgery, in which GB wall seen adherent to liver and a partial resection of involved parenchyma was also done. HPR came as Xanthogranulomatous Cholecystitis.
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