Year: 2016 | Month: January | Volume: 3 | Issue: 1 | Pages: 100-103
Idiopathic Eosinophilic Cholecystitis with Cholelithiasis - A Rare Pathological Entity
Savitri Singh1*, Sumit Giri1**, Saloni Gupta2**, Priyanka Chadha2**, Aparna Khandelwal2**, Jitendra Singh Nigam2#
1Associate Professor, 2Assistant Professor,
*Department of Pathology, Super Speciality Paediatric Hospital & Post Graduate Teaching Institute, Noida.
**Dept. of Pathology, Saraswathi Institute of Medical Sciences, Hapur, U.P.
#Dept. of Pathology, ANIIMS, Port Blair, India.
Corresponding Author: Sumit Giri
Eosinophilic cholecystitis (EC) is a rare and poorly understood entity first described in 1949. It may be defined as an inflammatory condition of gall bladder in which the transmural inflammatory infiltrate predominantly comprises of eosinophils that clearly overshadows the presence of any other inflammatory cell component. The etiology of EC is unclear, but suggested factors include eosinophilia-myalgia syndrome, allergies parasitic infestations, drug intake and local diathesis involving gallstones, parasites, acalculous cholecystitis, hyper eosinophilic syndrome (HES) and eosinophilic gastroenteritis (EGE). We report a case of a 50 year old female who presented with complaints of abdominal pain and tenderness in the right upper quadrant. Ultrasonography of the abdomen showed a distended gallbladder with multiple calculi. All the relevant laboratory investigations were within normal limits. Laparoscopic cholecystectomy was done under general anaesthesia. Histopathologic examination of the gallbladder showed numerous eosinophils comprising more than 90% of the inflammatory infiltrate in mucosa and lamina propria. In the absence of any apparent etiology after detailed workup of our case we considered it as one of idiopathic EC with cholelithiasis. Histopathology remains the mainstay for diagnosis of EC as there is no specific clinical/ radiological presentation. Though the treatment of choice for EC is cholecystectomy the patient must be evaluated meticulously to rule out other associated diseases which may have a worse prognosis than chronic cholecystitis itself.
Key words: Gall bladder, eosinophilic cholecystitis, cholelithiasis.