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

Gross processing

As per basic Gallbladder.

Microscopic evaluation

Look for signs of acute or chronic cholecystitis. If you find either, keep looking for the other as well, in case it is both acute and chronic.

Findings in acute cholecystisis

Main initial features are edema and hemorrhage.[1]

  • Initially often also congestion and fibrin deposition in and around the muscular layer.[2]
  • Later often necrosis of the mucosa and and deeper layers, with neutrophils.[2]
  • Variable reactive epithelial changes, which may resemble dysplasia.[2]

There may be fresh thrombi within small veins.[2]

Findings in chronic cholecystitis

Rokitansky-Aschoff sinus.

Typical features are:[4]

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

Other findings favoring the diagnosis are:[4]

  • Granulomas (from ruptured Rokitansky-Aschoff sinuses) strongly 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.

Lymph nodes

Look for reactive lymphadenopathy or metastasis. Further information: Lymph node

Microscopy report


  • Relevant findings from the evaluation.
  • Any cholelithiasis as per the gross report.

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))
Other legend

<< Decision needed between alternatives separated by / signs >>
{{Common findings / In case of findings}}
Link to another page

(Gallbladder, cholecystectomy:)
<<Acute and/or chronic>> cholecystitis.


  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


  1. Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H (2009). Sternberg's Diagnostic Surgical Pathology (5th ed.). Lippincott Williams & Wilkins. ISBN 978-0781779425. 
  2. 2.0 2.1 2.2 2.3 Hanni Gulwani. Gallbladder & extrahepatic bile ducts - Cholecystitis. Pathology Outlines. Topic Completed: 1 September 2012. Minor changes: 5 September 2019
  3. . Diseases of the Gallbladder. Abdominal Key (2019-09-29).
  4. 4.0 4.1 Hanni Gulwani. Gallbladder - Cholecystitis - Chronic cholecystitis. Topic Completed: 1 September 2012. Revised: 9 January 2020

Image sources