Difference between revisions of "Cholecystitis"

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==Microscopic evaluation==
 
==Microscopic evaluation==
 
===Findings in '''acute''' cholecystisis===
 
===Findings in '''acute''' cholecystisis===
Main initial features are '''edema''' and '''hemorrhage'''.<ref name=Mills>{{cite book |author= Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H   |title=Sternberg's Diagnostic Surgical Pathology |publisher=Lippincott Williams & Wilkins |location= |year=2009 |pages= {{{1|}}} |edition=5th |isbn=978-0781779425 |oclc= |doi= |accessdate=}}<\ref>
+
Main initial features are '''edema''' and '''hemorrhage'''.<ref name=Mills>{{cite book |author= Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H |title=Sternberg's Diagnostic Surgical Pathology |publisher=Lippincott Williams & Wilkins |location= |year=2009 |pages=|edition=5th |isbn=978-0781779425 |oclc= |doi= |accessdate=}}<\ref>
 
*Initially often also congestion and fibrin deposition in and around the muscular layer.<ref name=Gulwani-acute>{{cite web|url=https://www.pathologyoutlines.com/topic/gallbladderacutecholecystitis.html|title=Gallbladder & extrahepatic bile ducts - Cholecystitis|author=Hanni Gulwani|website=Pathology Outlines}} Topic Completed: 1 September 2012. Minor changes: 5 September 2019</ref>
 
*Initially often also congestion and fibrin deposition in and around the muscular layer.<ref name=Gulwani-acute>{{cite web|url=https://www.pathologyoutlines.com/topic/gallbladderacutecholecystitis.html|title=Gallbladder & extrahepatic bile ducts - Cholecystitis|author=Hanni Gulwani|website=Pathology Outlines}} Topic Completed: 1 September 2012. Minor changes: 5 September 2019</ref>
 
*Later often '''necrosis''' of the mucosa and and deeper layers, with neutrophils.<ref name=Gulwani-acute/>
 
*Later often '''necrosis''' of the mucosa and and deeper layers, with neutrophils.<ref name=Gulwani-acute/>

Revision as of 16:16, 13 August 2020

Author: Mikael Häggström [note 1]
Inflammation of the gallbladder:

Gross processing

As per basic Gallbladder.

Microscopic evaluation

Findings in acute cholecystisis

Main initial features are edema and hemorrhage.Cite error: Closing </ref> missing for <ref> tag

  • Later often necrosis of the mucosa and and deeper layers, with neutrophils.[1]
  • Variable reactive epithelial changes, which may resemble dysplasia.[1]

There may be fresh thrombi within small veins.[1]

Findings in chronic cholecystitis

Rokitansky-Aschoff sinus.

Typical features are:[2]

  • Smooth muscle hypertrophy in the muscularis
  • Mild inflammatory infiltrates
  • Rokitansky-Aschoff sinuses

Other findings favoring the diagnosis are:[2]

  • Granulomas (from ruptured Rokitansky-Aschoff sinuses) strogly favor the diagnosis.
  • Hyalinized collagen
  • Dystrophic calcification
  • Lymphoid aggregates
  • Atrophic and/or ulcerated mucosa
  • Metaplastic changes, such as gastric or intestinal mucosa

For a general gallbladder screening, see gallbladder.

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. 1.0 1.1 1.2 Cite error: Invalid <ref> tag; no text was provided for refs named Gulwani-acute
  2. 2.0 2.1 Hanni Gulwani. Gallbladder - Cholecystitis - Chronic cholecystitis. Topic Completed: 1 September 2012. Revised: 9 January 2020

Image sources