Gallbladder
Miscellaneous nontumor
Cholesterolosis

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 5 February 2018, last major update September 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Cholesterolosis[TI] gallbladder

Cite this page: Gulwani, H. Cholesterolosis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/gallbladdercholesterolosis.html. Accessed July 19th, 2018.
Definition / general
  • Present in 20% of cholecystectomy specimens, usually adult multiparous women
  • Asymptomatic
  • Associated with bile supersaturation with cholesterol but not with increased serum cholesterol
  • Due to accumulation of cholesterol esters and triglycerides in subepithelial macrophages and gallbladder epithelium
Gross description
  • Yellow, flat deposits on mucosal surface, focal or diffuse
  • May have speckled appearance ("strawberry gallbladder"), 20% are associated with cholesterol polyps
Gross images

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Various images

Microscopic (histologic) description
  • Foamy macrophages in lamina propria and epithelium
  • Villous mucosal hyperplasia with macrophages at tips of villi
  • Usually no or minimal cholecystitis
  • May be polypoid, rarely with heterotopic bone (Am J Surg Pathol 2000;24:895)
  • Usually changes are restricted to gallbladder and don't involve extrahepatic bile ducts
Microscopic (histologic) images

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Lipid laden histiocytes in lamina propria

Positive stains