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Difference between revisions of "Acute cholecystitis"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Acute cholecystitis -- very low mag.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Acute cholecystitis. [[H&E stain]]. | ||
| Micro = edema, hemorrhage, +/-neutrophils, +/-reactive epithelial changes | | Micro = edema, hemorrhage, +/-neutrophils, +/-reactive epithelial changes | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[chronic cholecystitis]], [[intestinal metaplasia of the gallbladder]], [[gallbladder dysplasia]], [[adenocarcinoma of the gallbladder]] | | LMDDx = [[chronic cholecystitis]], [[intestinal metaplasia of the gallbladder]], [[gallbladder dysplasia]], [[adenocarcinoma of the gallbladder]]. [[eosinophilic cholecystitis]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 18: | Line 18: | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = elderly individuals (50s and 60s) | | Clinicalhx = elderly individuals (50s and 60s) | ||
| Signs = | | Signs = Murphy's sign present | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = uncommon | | Prevalence = uncommon | ||
| Bloodwork = | | Bloodwork = | ||
| Line 27: | Line 27: | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
| Tx = cholecystectomy | |||
}} | }} | ||
'''Acute cholecystitis''', abbreviated '''AC''', is a relatively uncommon [[gallbladder]] pathology when compared to [[chronic cholecystitis]]. It is usually associated with [[gallstones]] and seen in older individuals. | '''Acute cholecystitis''', abbreviated '''AC''', is a relatively uncommon [[gallbladder]] pathology when compared to [[chronic cholecystitis]]. It is usually associated with [[gallstones]] and seen in older individuals. | ||
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*Less common than ''chronic cholecystitis''. | *Less common than ''chronic cholecystitis''. | ||
*Usually due to gallstones.<ref name=Ref_Sternberg5_1606>{{Ref Sternberg5|1606}}</ref> | *Usually due to gallstones.<ref name=Ref_Sternberg5_1606>{{Ref Sternberg5|1606}}</ref> | ||
*Classically older individuals (50s and 60s) with a slight female predominance.<ref name=Ref_Sternberg5_1606>{{Sternberg5|1606}}</ref> | *Classically older individuals (50s and 60s) with a slight female predominance.<ref name=Ref_Sternberg5_1606>{{Ref Sternberg5|1606}}</ref> | ||
Notes: | Notes: | ||
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*[[Gallbladder adenocarcinoma]]. | *[[Gallbladder adenocarcinoma]]. | ||
*[[Intestinal metaplasia of the gallbladder]]. | *[[Intestinal metaplasia of the gallbladder]]. | ||
*[[Eosinophilic cholecystitis]] - has >90% eosinophils. | |||
===Images=== | |||
<gallery> | |||
Image: Acute cholecystitis -- very low mag.jpg | AC - very low mag. | |||
Image: Acute cholecystitis -- low mag.jpg | AC - low mag. | |||
Image: Acute cholecystitis -- intermed mag.jpg | AC - intermed. mag. | |||
Image: Acute cholecystitis - a -- intermed mag.jpg | AC - intermed. mag. | |||
Image: Acute cholecystitis - b -- intermed mag.jpg | AC - intermed. mag. | |||
</gallery> | |||
===Special types=== | ===Special types=== | ||
| Line 74: | Line 85: | ||
Microscopic: | Microscopic: | ||
*[[Necrosis]] of gallbladder wall (muscularis propria).<ref> | *[[Necrosis]] of gallbladder wall (muscularis propria).<ref>Struetker C. 25 February 2009.</ref> | ||
==Sign out== | ==Sign out== | ||
<pre> | |||
Gallbladder, Cholecystectomy: | |||
- Acute cholecystitis with cholelithiasis. | |||
</pre> | |||
=====Block letters===== | |||
<pre> | <pre> | ||
GALLBLADDER, CHOLECYSTECTOMY: | GALLBLADDER, CHOLECYSTECTOMY: | ||
- ACUTE CHOLECYSTITIS. | - ACUTE CHOLECYSTITIS. | ||
- CHOLELITHIASIS. | - CHOLELITHIASIS. | ||
</pre> | |||
====Necrosis of wall==== | |||
<pre> | |||
Gallbladder, Cholecystectomy: | |||
- Acute cholecystitis with multiple mucosal erosions and focal necrosis of the gallbladder wall. | |||
</pre> | </pre> | ||
<pre> | <pre> | ||
GALLBLADDER, CHOLECYSTECTOMY: | GALLBLADDER, CHOLECYSTECTOMY: | ||
- ACUTE AND CHRONIC CHOLECYSTITIS WITH MULTIPLE MUCOSAL EROSIONS AND FOCAL NECROSIS OF THE GALLBLADDER WALL. | - ACUTE AND CHRONIC CHOLECYSTITIS WITH MULTIPLE MUCOSAL EROSIONS AND FOCAL | ||
NECROSIS OF THE GALLBLADDER WALL. | |||
</pre> | </pre> | ||
====Gangrenous cholecystitis==== | |||
<pre> | <pre> | ||
GALLBLADDER, CHOLECYSTECTOMY: | GALLBLADDER, CHOLECYSTECTOMY: | ||
- GANGRENOUS CHOLECYSTITIS. | - GANGRENOUS CHOLECYSTITIS. | ||
- CHOLELITHIASIS. | - CHOLELITHIASIS. | ||
</pre> | |||
<pre> | |||
Gallbladder, Cholecystectomy: | |||
- Gangrenous (acute) cholecystitis with cholelithiasis. | |||
</pre> | |||
====Xanthomatous lymph node present==== | |||
<pre> | |||
GALLBLADDER, CHOLECYSTECTOMY: | |||
- ACUTE CHOLECYSTITIS. | |||
- CHOLELITHIASIS. | |||
- BENIGN LYMPH NODE WITH NONNECROTIZING GRANULOMAS, XANTHOMATOUS APPEARANCE. | |||
- NEGATIVE FOR DYSPLASIA. | |||
</pre> | </pre> | ||
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====Alternate==== | ====Alternate==== | ||
The sections show gallbladder wall with hemorrhage, activated fibroblasts and focal | The sections show an inflamed gallbladder wall with hemorrhage, activated fibroblasts and focal | ||
necrosis. The mucosa is partially eroded. Abundant neutrophils and eosinophils are present. | necrosis. The mucosa is partially eroded. Abundant neutrophils and eosinophils are present. No significant nuclear changes are apparent. | ||
==See also== | ==See also== | ||