Topic Completed: 1 September 2012

Revised: 5 September 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Cholesterolosis[TI] gallbladder

Hanni Gulwani, M.B.B.S.
Page views in 2018: 4,876
Page views in 2019 to date: 5,039
Cite this page: Gulwani H. Cholesterolosis. website. Accessed September 18th, 2019.
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
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