Gallbladder cholesterolosis

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Gallbladder cholesterolosis
Diagnosis in short

Gallbladder cholesterolosis. H&E stain.

LM abundant foamy macrophages in the lamina propria, +/-papillary hyperplasia
LM DDx cholesterol polyp of gallbladder
Gross gallbladder mucosa with strawberry-like texture
Site gallbladder

Associated Dx chronic cholecystitis, obesity, cholelithiasis
Clinical history biliary colic - due to chronic cholecystitis
Prevalence common
Prognosis benign

Gallbladder cholesterolosis, also known simply as cholesterolosis, is a common gallbladder pathology associated with chronic cholecystitis.

Informally, gallbladder cholesterolosis is known as strawberry gallbladder.

General

  • Common in chronic cholecystitis.
  • Seen in ~13% of cases in a large series of 23,304 gallbladders.[1]
    • Slightly more common in women than men (14% of cases in women versus 10% of cases in men).
  • Less likely to be associated with cancer than gallbladders without cholesterolosis; relative risk of cancer in non-cholesterolosis gallbladders 9.2.[1]
  • Associated with yellow gallstones (cholesterol type gallstones).

Gross

Features:

  • Mucosa has strawberry-like appearance.
    • The similarity is in the surface texture.
    • The colour (yellow) is not strawberry-like.

Image

Microscopic

Features:

  • Numerous foamy macrophages in the lamina propria.
  • +/-Papillary hyperplasia.[2]

DDx:

Image

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GALLBLADDER, CHOLECYSTECTOMY:
- CHRONIC CHOLECYSTITIS WITH CHOLESTEROLOSIS.
- CHOLELITHIASIS.
GALLBLADDER, CHOLECYSTECTOMY:
- CHRONIC CHOLECYSTITIS WITH FOCAL FOAMY MACROPHAGES IN LAMINA PROPRIA.
- CHOLELITHIASIS.

See also

References

  1. 1.0 1.1 Roa, I.; de Aretxabala, X.; Ibacache, G.; Muñoz, S. (Jul 2010). "[Association between cholesterolosis and gallbladder cancer].". Rev Med Chil 138 (7): 804-8. PMID 21043073.
  2. Celoria, GC.; Rodríguez Otero, JC.; Proske, SA.; Vallilengua, C. (1994). "Papillary hyperplasia and cholesterolosis of the gallbladder.". Medicina (B Aires) 54 (1): 31-4. PMID 7990683.