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Gallbladder Pathology Online

Pathology of the Porcelain Gallbladder

Dr Sampurna Roy MD


Syn: Also known as calcified gallbladder, calcifying cholecystitis, or cholecystopathia chronica calcarea.

Porcelain gallbladder is the term used to denote the end-stage of chronic cholecystitis in which there is gallbladder wall calcification.

It is a rare condition occuring in 0.06 and 0.08%  of cholecystectomy specimens.

Calcified gallbladders are five times more common in women than in men.

The term porcelain gallbladder describes the blue discoloration and brittle consistency of the gallbladder on pathology.

Gross: The gall bladder is contracted with a slightly thickened or grossly thickened wall, which is brittle and calcified.


- Gallbladder wall chronic irritation by gallstones (present in up to 95% of the cases). Cystic duct obstruction with bile stagnation cause mucosal calcium carbonate precipitation.

- Dystrophic calcification, errors of calcium metabolism, inflammation and ischemia.

- Bile stasis, chronic degeneration and regeneration with mucosal dysplasia likely contribute to carcinogenesis.

- Porcelain gallbladder can also be seen,in patients who have acalculous cholecystitis.

Microscopic features: Histologically, the wall is extensively fibrous with some hyalinization of the collagen.

The calcification is in broad bands or as small intramural concretions.

The mucosa may be frequently absent and replaced by fibrous tissue.

Porcelain gallbladder is an uncommon finding, however, due to the greatly increased chance of malignancy, it must be considered in patients who have cystic type calcification in the right upper abdominal quadrant.

A calcified gallbladder is associated with an increased risk of gallbladder cancer, but at a much lower rate than previously estimated.

The incidence of cancer depends on the pattern of calcification, selective mucosal calcification poses a significant risk of cancer whereas diffuse intramural calcification does not.


Further reading:

Porcelain Gallbladder Mimicking Carcinoma Gallbladder-a Case Report and Review of Literature.

Porcelain gallbladder: a benign process or concern for malignancy?

Intrahepatic porcelain gallbladder: coexistence of pathologies.

Porcelain gallbladder complicated with pancreas divisum.

Eosinophilic dysplasia of the gallbladder: a hitherto undescribed variant identified in association with a "porcelain" gallbladder.

Porcelain gallbladder with extrahepatic bile duct obstruction in a child

Laparoscopic cholecystectomy in patients with porcelain gallbladder based on the preoperative ultrasound findings 

Porcelain gallbladder is not associated with gallbladder carcinoma  

Case of mucinous adenocarcinoma with porcelain gallbladder

Is the laparoscopic approach appropriate for porcelain gallbladder?

Cholecystoduodenal fistula in a porcelain gallbladder.

Pre- and intraoperative evaluation of biliary system for successful laparoscopic cholecystectomy in porcelain gallbladder patients 

Carcinoma in the porcelain gallbladder: a relationship revisited

Porcelain gallbladder is not associated with gallbladder carcinoma.

Porcelain gallbladder.

A porcelain gallbladder affecting the assessment of bone mineral content

Porcelain gallbladder: relation between its type by ultrasound and incidence of cancer. 

Porcelain gallbladder in a child: a case report and review.

Right upper quadrant calcification: porcelain gallbladder disease

"Porcelain gallbladder"; a pediatric case report.

Porcelain gallbladder: relation between its type by ultrasound and incidence of cancer.

A porcelain gallbladder affecting the assessment of bone mineral content.




Dr  Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)









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