Xanthogranulomatous cholecystitis mimicking gallbladder carcinoma

Table 1 Key imaging findings, diagnostic interpretation, and sources of overlap between xanthogranulomatous cholecystitis and gallbladder carcinoma

Imaging finding	Typical interpretation	Relative diagnostic value	Why it favors this diagnosis	Source of diagnostic overlap
Diffuse wall thickening	XGC	Moderate	Chronic transmural inflammation	May occur in infiltrative GBC
Continuous mucosal line	XGC	Higher	Relative preservation of mucosal integrity	Can be partially preserved in early GBC
Intramural hypoattenuating nodules	XGC	Higher	Xanthogranulomatous inflammation	Not universally present
Gallstones	XGC	Limited	Chronic obstruction and inflammation	Common in both diseases
Intraluminal mass	GBC	Moderate	Neoplastic tissue proliferation	Inflammatory pseudotumoral lesions may mimic mass formation
Lymphadenopathy	GBC	Moderate	Regional tumor spread	Reactive inflammatory nodes may occur in XGC
Biliary obstruction	GBC	Moderate	Ductal invasion or compression	Severe inflammatory disease may produce similar findings
Hepatic invasion	GBC	Higher	Direct local extension	Inflammatory infiltration may mimic true invasion
Vascular encasement	GBC	Higher	Advanced locoregional disease	Rare inflammatory pseudoinvasion

Relative diagnostic value is intended as a qualitative assessment based on the consistency and discriminatory relevance of each finding across the studies discussed in this review; it does not represent a formal grading of the level of evidence. XGC: Xanthogranulomatous cholecystitis; GBC: Gallbladder carcinoma.