Chronic cholecystitis is
rarely seen in the absence of lithiasis.
The associated stones are
of the mixed or combined type.
The female to male ratio is 3 to 1 with the peak
incidence in the 5th and 6th decades.
bladder may be shrunken and fibrotic or distended depending on its
level of obstruction and the duration of disease.
sinuses are usually present with or without inspissated bile.
Bile granulomas may be seen in relation to Rokitansky-Aschoff sinuses.
There is variable fibrosis throughout the wall. The chronic inflammation is
There may be changes of previous acute cholecystitis.
of chronic cholecystitis showing thick mucosa, absence of normal
folds and a dense chronic inflammatory infiltrate. The muscle coat
is hypertrophied and there are relatively few inflammatory cells.
Ulcer associated cell lineage
may be seen in association with intestinal metaplasia and argentaffin cells.
Chronic follicular cholecystitis
occasionally occurs where prominent lymphoid follicles are seen
throughout the wall. This is more common in patients with
These need to be differentiated from gallbladder involvement by
Lymphoma of Gallbladder
reactions with cholesterol crystals may be seen within the thickened
fibrous wall underlying an ulcer.
is another morphologic form of chronic cholecystitis, with formation
of Michaelis-Gutmann bodies.