横田 重樹¹, 岡 博子², 大内田 祐一¹, 櫻田 啓子¹, 嶋 三恵子¹, 中井 隆志², 川崎 靖子², 根引 浩子², 堀井 勝彦³, 松山 光春³, 山崎 修³, 井上 健⁴

Shigeki YOKOTA¹, Hiroko OKA², Yuichi OUCHIDA¹, Keiko SAKURADA¹, Mieko SHIMA¹, Takashi NAKAI², Yasuko KAWASAKI², Hiroko NEBIKI², Katsuhiko HORII³, Mitsuharu MATSUYAMA³, Osamu YAMAZAKI³, Takeshi INOUE⁴

¹大阪市立総合医療センター中央臨床検査部, ²大阪市立総合医療センター消化器内科, ³大阪市立総合医療センター消化器外科, ⁴大阪市立総合医療センター病理部

¹Central Clinical Laboratory, Osaka City General Hospital, ²Department of Gastroenterology, Osaka City General Hospital, ³Department of Surgery, Osaka City General Hospital, ⁴Department of Pathology, Osaka City General Hospital

キーワード : cholecystitis, cholelithiasis, ultrasonography, CA 19-9

We studied 15 cases of xanthogranulomatous cholecystitis (XGC) that were diagnosed from 633 specimens of gallbladder after cholecystectomy performed from January 1994 to June 2000. Preoparative ultrasonographic diagnoses of these cases were as follows: gallbladder cancer in 8 patients, gallstones in 5, and cholecystitis in 2. Patients were aged 54 to 83 year-old. The main symptoms were abdominal pain in 11 cases and high fever in 9 cases. Additionally, 13 cases were positive for CRP; leucocytosis exceeded 10 000 /mm³ in 5 cases; and serum CA 19-9 level was greater than 2000 IU/ml in 2 cases. Gallbladder wall thickness ranged from 2 to 15 mm, and ultrasonography showed gallstones in 14 cases. Although the characteristic ultrasonographic findings of XGC in previous reports included irregular wall thickening and hyperehoic lesions in the wall, wall thickening was not always present in the cases discussed here.