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Cholecystitis & cholelithiasis

Microscopic description

A. The section shows gallbladder wall with a minimal superficial lymphocytic infiltrate. No Rokitansky-Aschoff sinuses are identified. There is no cholesterolosis, no dysplasia and no metaplasia.

Final diagnosis

A. Gallbladder, cholecystectomy: i) minimal chronic cholecystitis ii) cholelithiasis

Acute cholecystitis versus chronic cholecystitis

  • Clinical impression.
  • Favour chronic:
    • Age - 40s or less.
    • RK sinuses.
    • Papillary hyperplasia.
    • Cholesterolosis (multiple foci) - 2x.
  • Favour acute:
    • Gallstone in neck (gross description or radiology).
    • Edema.
    • Reactive epithelial changes.
    • Several PMNs - 2x.
    • Wall thickness > 3 mm (gross description or radiology) - required for acute.

gallbladder adenomyosis

comet tail artifact