Xanthogranulomatous Colitis masquerading as carcinoma of colon

Xanthogranulomatous inflammation (XGI) is an uncommon pathological diagnosis involving various organ systems, the most common being the gall bladder and kidney. It can masquerade as a malignant mass thus, requiring a clinical suspicion for accurate and timely diagnosis. A 65-year-old woman presented with acute onset of obstipation and vomiting suggesting acute obstruction. Contrast enhanced computed tomography of abdomen revealed a solid irregular mass in the ascending colon with large necrotic areas and surrounding enlarged nodes suggestive of malignancy arising from right colon. Right hemi-colectomy was performed. Histopathology of the surgical specimen showed florid inflammatory infiltrate with collection of histiocytes, lymphocytes and polymorphs. Further immunohistochemistry was conducted, and CD68 and CD45 were found to be positive and pan-cytokeratin was negative. A clinico-pathological diagnosis was thus established to be xanthogranulomatous colitis.