alexa A Case of Xanthogranulomatous Cholecystitis with High C
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

A Case of Xanthogranulomatous Cholecystitis with High CA19-9 Levels that Normalized Post-Cholecystectomy

Tomoya Iida1*, Takeya Adachi1, Suguru Nakagaki1, Takashi Yabana1, Akira Goto1, Yoshihiro Kondo1, Takashi Kawamata2, Takuji Ota2, Yoshito Watanabe2, Hayato Echizenya2, Hiroshi Gondo2 and Kiyoshi Kasai3
1Department of Gastroenterology, Otaru City General Hospital, Japan
2Department of Surgery, Otaru City General Hospital, Japan
3Department of Diagnostic Pathology, Otaru City General Hospital, Japan
*Corresponding Author : Tomoya Iida
Department of Gastroenterology
Otaru City General Hospital, Japan
Tel: +81-134-25-1211
Fax: +81-134-32-6424
E-mail: [email protected]
Received January 10, 2016; Accepted February 14, 2016; Published February 18, 2016
Citation: Iida T, Adachi T, Nakagaki S, Yabana T, Goto A, et al. (2016) A Case of Xanthogranulomatous Cholecystitis with High CA19-9 Levels that Normalized Post-Cholecystectomy. J Clin Case Rep 6:710. doi:10.4172/2165-7920.1000710
Copyright: © 2016 Iida T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

The patient was an 81-year-old male. His blood tests revealed a mild hepatic dysfunction and an abnormally high Carbohydrate antigen 19-9 (2,830 U/ml). Ultrasonography, contrast-enhanced computed tomography and magnetic resonance cholangiopancreatography were carried out, and showed that the gallbladder was filled with microcalculi, that the gallbladder was enlarged, and that the gallbladder wall had thickened; however, no calculi were found in the common bile duct, and positron emission tomography was performed for the detection of malignancies but the findings were poor; therefore, the condition was diagnosed as calculous cholecystitis, and cholecystectomy was performed. The pathological findings indicated a xanthogranulomatous cholecystitis, and the levels of Carbohydrate antigen 19-9 returned to normal immediately after surgery. The immunostaining of Carbohydrate antigen 19-9 showed that epithelial mucosa of the gallbladder, cytoplasm of multinucleated foreign-body giant cells, and infiltrating macrophages were positive, and suggested that the abnormally high levels of Carbohydrate antigen 19-9 may have been due to xanthogranulomatous cholecystitis. In some cases, Carbohydrate antigen 19-9 levels can be high in benign diseases such as cholangitis and pancreatitis, but markedly high levels are rare. Only two cases of xanthogranulomatous cholecystitis have been reported to have shown abnormally high Carbohydrate antigen 19-9 that returned to normal after cholecystectomy. We report our experience along with a discussion based on the literature.

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