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Gallbladder

Miscellaneous non-tumor

Cholesterolosis

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 13 February 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● 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
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● 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

Micro description
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● 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

Micro images
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Lipid laden histiocytes in lamina propria

Virtual slides
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Cholesterolosis

Positive stains
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● Oil red O / Sudan black (on frozen tissue)

Additional references
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● Klin Med (Mosk) 2002;80:14, Minerva Gastroenterol Dietol 2003;49:217, Saudi Med J 2004;25:1226

End of Gallbladder > Miscellaneous non-tumor > Cholesterolosis

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