Xanthogranulomatous Cholecystitis: Diagnostic and Surgical Challenges

Acute xanthogranulomatous cholecystitis (XGC) is a rare inflammatory condition of the gallbladder characterized by marked xanthomatous and granulomatous changes within the gallbladder wall(1). The pathophysiology of XGC involves severe inflammation, fibrosis, and lipid-laden macrophage infiltration, often mimicking the presentation of gallbladder carcinoma. Clinically, XGC manifests with right upper quadrant pain, fever, and signs of systemic inflammation, such as elevated C-reactive protein (CRP) and leukocytosis. This overlap in clinical features with acute and chronic cholecystitis complicates preoperative differentiation from malignant gallbladder lesions.