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

Gross processing

As per basic Gallbladder.

Microscopic evaluation

Classify cholecystitis as acute, chronic or 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:[3]

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

Other findings favoring the diagnosis are:[3]

  • 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. 3.0 3.1 Hanni Gulwani. Gallbladder - Cholecystitis - Chronic cholecystitis. Topic Completed: 1 September 2012. Revised: 9 January 2020