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Gallbladder

Histology (normal) - Gallbladder


Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 10 February 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Has mucosa, muscularis propria and serosa on free surface
● No muscularis mucosa or submucosa is present

Terminology
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Mucosa:
● Variable branching folds, more prominent if gallbladder not distended

Surface epithelium:
● Composed of single layer of uniform, tall columnar cells with basal nuclei, indistinct nucleoli, pale cytoplasm due to sulfomucins
● Few PAS+ apical vacuoles; also pencil cells (small, darkly staining columnar cells), inconspicuous basal epithelial cells, T lymphocytes
● No goblet cells, myoepithelial cells or melanocytes
● Neck region has tubuloalveolar mucus glands that secrete sulfo-, sialo- and neutral mucin and contain neuroendocrine cells
● True glands are not present outside the neck

Lamina propria:
● Loose connective tissue with blood vessels, lymphatics, occasional chronic inflammatory cells (IgA secreting plasma cells), no neutrophils

Muscular layer:
● Circular, longitudinal and oblique smooth muscle fibers without distinct layers, resembles muscularis mucosa
● Adjacent to lamina propria without an intervening submucosa

Adventitia:
● Perimuscular connective tissue composed of collagen, elastic tissue, fat, vessels, lymphatics, nerves, paraganglia

Peritoneum:
● Lines gallbladder that is not directly attached to liver, is continuous with that of liver

Aberrant bile ducts (ducts of Lushka):
● Present in 10% of cholecystectomy specimens, often buried in gallbladder wall adjacent to liver, may contain collar of fibrous tissue, may communicate with intrahepatic bile ducts
● Histologically composed of lobular aggregates of small ductules lined by bland cuboidal to columnar biliary type epithelium (Am J Surg Pathol 2011;35:883)

Rokitansky-Aschoff sinuses:
● Outpouchings of gallbladder mucosa that penetrate into muscle wall
● May be acquired herniations

Larger accessory bile ducts:
● Join with cystic or hepatic ducts, may be present within gallbladder bed

Mucin-secreting accessory glands:
● Prominent near terminus of common bile duct

Micro images
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Cross section

Virtual slides
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Normal gallbladder

Positive stains
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Surface epithelium: EMA, low molecular weight keratin, alpha-1-antitrypsin, alpha-1-antichymotrypsin, polyclonal CEA

End of Gallbladder > Histology (normal) - Gallbladder


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