B

Most studies, including a comparative immunohistochemical analysis showing minimal p53 and PCNA expression in xanthogranulomatous cholecystitis (XGC) compared with gallbladder carcinoma, conclude that XGC represents an inflammatory, not premalignant, process [Ghosh et al., 2011, PMID 21459725]. Large clinicopathologic series likewise find only rare, coincidental co-occurrence with carcinoma and no evidence that XGC itself evolves into cancer [Dixit et al., 1998, PMID 9590403].