Eosinophilic Cholecystitis
Vikram Deshpande, MD
Key Facts
Terminology
Inflammatory disease of gallbladder in which inflammatory infiltrate is composed predominantly of eosinophils
Microscopic Pathology
Dense eosinophilic infiltrate of gallbladder with or without lymphocytic inflammatory component
Careful evaluation of specimen to exclude parasite
In “true” EC, close to 100% of inflammatory component is composed of eosinophils
So-called lymphoeosinophilic cholecystitis shows significant component of lymphocytes as well
Top Differential Diagnoses
Acute and subacute cholecystitis with cholelithiasis
Autoimmune pancreatitis-associated cholecystitis
 This case of eosinophilic cholecystitis shows a transmural infiltrate consisting of both lymphocytes and eosinophils. |
 This case of “pure” eosinophilic cholecystitis shows an infiltrate composed entirely of eosinophils extending into the wall of the gallbladder. |
TERMINOLOGY
Abbreviations
Eosinophilic cholecystitis (EC)
Definitions
Inflammatory disease of gallbladder in which inflammatory infiltrate is composed predominantly of eosinophils
ETIOLOGY/PATHOGENESIS
Hypersensitivity Reaction
Hypersensitivity reaction to drugs, infections (Echinococcus, Clonorchis sinensis)
Hypersensitive reaction to bile and bile stones has been hypothesized but never proven
Other Eosinophilic Diseases
Eosinophilic cholangitis
Occasionally, biliary tree may be involved, leading to biliary strictures
Eosinophilic gastroenteritis
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