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Difference between revisions of "Chronic cholecystitis"
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[[File:Reactive change in cholecystitis A sl 3.png| Extensive Rokitansky-Aschoff sinuses in a 64 year ood woman]] | [[File:Reactive change in cholecystitis A sl 3.png| Extensive Rokitansky-Aschoff sinuses in a 64 year ood woman]] | ||
[[File:Reactive change in cholecystitis A sl 4.png| Extensive Rokitansky-Aschoff sinuses in a 64 year ood woman]]<br> | [[File:Reactive change in cholecystitis A sl 4.png| Extensive Rokitansky-Aschoff sinuses in a 64 year ood woman]]<br> | ||
Extensive Rokitansky-Aschoff sinuses in a 64 year ood woman. A. Extending from a benign, chronically inflamed plicae are Rikitansky-Aschoff sinuses. Note their travel in between muscle bundles can be recognized as continuity to the surface. B. In between the gall stone at lower left and the lymphoid aggregate at upper right lies the gallbladder wall. Note the longitudinal extensions of the Rokitansky-Aschoff sinuses, as well as the ballooning outside the wall at lower right. C. The mucosa shows extensive reactive branching. Note again the predominant extension between muscle bundles, recognizable by the stroma about the sinuses, some of which are branched, pushing the muscle wall aside. There is no desmoplasia, but some gallbladder | Extensive Rokitansky-Aschoff sinuses in a 64 year ood woman. A. Extending from a benign, chronically inflamed plicae are Rikitansky-Aschoff sinuses. Note their travel in between muscle bundles can be recognized as continuity to the surface. B. In between the gall stone at lower left and the lymphoid aggregate at upper right lies the gallbladder wall. Note the longitudinal extensions of the Rokitansky-Aschoff sinuses, as well as the ballooning outside the wall at lower right. C. The mucosa shows extensive reactive branching. Note again the predominant extension between muscle bundles, recognizable by the stroma about the sinuses, some of which are branched, pushing the muscle wall aside. There is no desmoplasia, but some gallbladder adenocarcinomas show little recognizable desmoplasia. D. The focus on the right is difficult to identify as lying between muscle bundles. The triple parallel tubules argue against neoplasia. The lack of cancerous nuclear change is important as well. | ||
[[File:5gb41630891386282 sl 1.png| Chronic cholecystitis with reactive changes.]] | |||
[[File:5gb41630891386282 sl 2.png| Chronic cholecystitis with reactive changes.]] | |||
[[File:5gb41630891386282 sl 3.png| Chronic cholecystitis with reactive changes.]] | |||
[[File:5gb41630891386282 sl 4.png| Chronic cholecystitis with reactive changes.]]<br> | |||
Chronic cholecystitis with reactive epithelial atypia in a 92 year old. A. Lymphoid follicles are associated with chronically inflamed plicae. B. Neutrophils lie within cytoplasm of epithelium. Nuclei show variability in size and, to a lesser degree, shape. Some cells are multinucleated. Polarity is generally, but not always, preserved, with most nuclei at the base of the cell, with the longer nuclear dimension, when the nucleus is not round, being perpendicular to the luminal surface. C. Monoclonal CEA stains neutrophils, but not epithelial cells. D. CD10 stains the luminal surfaces of epithelial cells, a finding that militates against dysplasia. | |||
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