Xanthogranulomatous Cholecystitis

Comments:
Xanthogranulomatous Cholecystitis (XC): Leakage of bile through ulcers/fissures or ruptured Rokitansky-Aschoff sinuses is a common finding in XC. The presence of bile in subepithelial mesenchyme incites a vigorous inflammatory response (as seen here). Superimposed bacterial infection may also contribute.

The inflammatory infiltrate consists of lipid-laden macrophages, myofibroblastic cells, plasma cells, lymphocytes and acute inflammatory cells. Besides xanthogranulomas, there are foreign body-type granulomas consisting of multinucleated giant cells and foamy macrophages around cholesterol clefts and bile concretions.

Image courtesy of: @Patholwalker