第8巻 2012年4月　第2号

■症例報告

術前診断が困難であった黄色肉芽腫性胆嚢炎の1症例
石田　隆志¹, 橋本　大定¹, 赤松　延久¹, 小澤　文明¹, 田丸　淳一^2
1埼玉医科大学総合医療センター肝胆膵・小児外科，埼玉
²埼玉医科大学総合医療センター病理部，埼玉

A Case of Xanthogranulomatous Cholecystitis with Difficulty in Preoperative Diagnosis
Takashi Ishida¹, Daijo Hashimoto¹, Nobuhisa Akamatsu¹, Fumiaki Ozawa¹ and Junichi Tamaru^2
1)Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University
²⁾Department of Diagnostic Pathology, Saitama Medical Center, Saitama Medical University

A 72-year-old woman was referred to our hospital with jaundice, right hypochondrial pain, and fever. Enhanced computed tomography revealed a greatly thickened gallbladder wall, a large gallstone (Φ33 mm), and encasement of the right hepatic artery. Percutaneous transhepatic cholangiography revealed severe stenosis extending from the hilar bifurcation of the bile ducts to the common bile duct. Pathological examination of the gallbladder wall during surgery for gallstone ileus carried out 4 days after percutaneous transhepatic portal vein embolization led to a final diagnosis of xanthogranulomatous cholecystitis. Physicians need to be alert to the possibility of xanthogranulomatous cholecystitis, which is difficult to differentiate from advanced gallbladder cancer.

日医大医会誌 2012; 8(2), 157-161

Key words
xanthogranulomatous cholecystitis, gallbladder cancer, percutaneous transhepatic portal vein embolization, gallstone ileus

Correspondence to
Takashi Ishida, Department of Hepato-Biliary-Pancreatic and Pediatric Surgery, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
E-mail：isd007@hotmail.com

受付：2012年1月27日　受理：2012年2月24日