Chronic Cholecystitis

Kari D. Caradine, MD

Key Facts

Etiology/Pathogenesis

Almost always associated with gallstones

Clinical Issues

More common in women; approximately 3:1

Microscopic Pathology

Predominantly mononuclear inflammatory infiltrate with lymphocytes dominating over plasma cells and histiocytes
Minor component of eosinophils and neutrophils may be present
Wall thickening secondary to muscular hypertrophy and fibrosis
Metaplastic changes; most common is antral type
Rokitansky-Aschoff sinuses

Diagnostic Checklist

Presence of gallstones is neither necessary nor sufficient for diagnosis of chronic cholecystitis

This section illustrates a normal gallbladder with typical wall thickness and a normal complement of chronic inflammatory cells.

This example of chronic cholecystitis shows an increase in chronic inflammation within the lamina propria and the submucosa. A Rokitansky-Aschoff sinus

is present as well.

TERMINOLOGY

Definitions

Chronic inflammation of gallbladder

ETIOLOGY/PATHOGENESIS

Pathogenesis

Poorly understood
Almost always associated with gallstones
Possible association with trauma induced by gallstones, prior episodes of acute cholecystitis, or abnormal composition of bile

CLINICAL ISSUES

Epidemiology