Cholesterol Polyps and Cholesterolosis
Kari D. Caradine, MD
Key Facts
Terminology
Accumulation of neutral lipid within macrophages of lamina propria of gallbladder
Macroscopic Features
Lipid droplets appear as yellow flecks or streaks against green or red background (“strawberry” gallbladder)
Lipid droplets may form polypoid excrescences, called cholesterol polyps, that project into lumen
May contain cholesterol gallstones
Microscopic Pathology
Foamy macrophages with small dark nuclei within lamina propria of gallbladder mucosa
Cholesterol polyps have vascular stalk and villous projections
Lamina propria of polyp is filled with foamy lipid containing macrophages
 Gross photograph of a gallbladder with cholesterolosis shows numerous yellow dots with a red-brown background  , somewhat resembling a strawberry. In addition, there is a cholesterol polyp  . |
 Hematoxylin and eosin section shows multiple villi with expansion of the lamina propria by numerous foamy macrophages, characteristic of cholesterolosis  . |
TERMINOLOGY
Definitions
Accumulation of neutral lipid within macrophages of lamina propria of gallbladder
ETIOLOGY/PATHOGENESIS
Pathogenesis
Poorly understood
May reflect increased hepatic synthesis of lipids or increased absorption and esterification by gallbladder
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