case_images: PMC6380101_01
case_images: (a) Computed tomography left hepatic lobe abscess (arrow). (b) Computed tomography subhepatic abscess (arrow)
case_images: JGID-11-47-g001.jpg
case_images: PMC6380101_01_JGID-11-47-g001.jpg
case_images: F1
case_images: Two years prior, he had presented with right upper quadrant pain and was found to have emphysematous cholecystitis and a liver abscess [Figure 1a]. Computed tomography (CT) of the abdomen revealed a multiloculated fluid collection, measuring approximately 5.1 cm x 3.1 cm x 7.1 cm, interposed between the right lateral upper abdominal wall and involving the lateral and inferior aspect of the right hepatic lobe [Figure 1b].
case_images: (a)Fluid aspirated from abscess. (b) Yellow cholesterol material surrounded by inflammatory cells including foreign body giant cells (H and E, x100). (c) Additional fragment of cholesterol material with foreign body giant cell reaction and abscess (H and E, x200)
case_images: JGID-11-47-g002.jpg
case_images: PMC6380101_01_JGID-11-47-g002.jpg
case_images: F2
case_images: CT-guided aspiration of this collection showed a pink-colored fluid [Figure 2a]. On histological evaluation, a neutrophilic and histioplasmacytic inflammatory cell infiltrate was appreciated along with a foreign body giant cell reaction with entrapped lipid cleft deposits, consistent with cholesterol gallstone fragments [Figures 2b and 2c].