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Basic Pathology. Dr. Samina Qamar FCPS Histopathology. CHRONIC CHOLECYSTITIS.
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Basic Pathology Dr. Samina Qamar FCPS Histopathology
The opened gallbladder contains a single large gallstone • The wall of the gallblader is thickened • The mucosal lining has lost all of its normal appearance with the shaggy roughened surface indicating extensive necrosis and ulceration
CHRONIC CHOLECYSTITIS • Etiology•Unknown • Pathogenesis•The pathogenesis of chronic cholecystitis is not well understood. •There may be a history of repeated attacks of acute cholecystitis. •However, in many instances, it appears to arise without any antecedent disease. •In one-third to one-quarter of cases, bacteria may be cultured from the fluids from within the gall bladder.
CHRONIC CHOLECYSTITIS • Epidemiology•Chronic cholecystitits occurs in the same age group as acute cholecystitis, predominantly women in the 30-50 year age group. • Fat, fertile, female, forty. •This is almost always associated with cholelithiasis.
CHRONIC CHOLECYSTITIS • Clinical•May be aymptomatic or present as acute cholecystitis on a background of chronic disease. • •Other manifestations may be of biliary colic (due to the stones invariably present with chronic cholecystitis), fistula formation, hydrops of the gallbladder or perforation.
CHRONIC CHOLECYSTITIS • General Gross Description•Grossly, the gall bladder may be enlarged, normal in size, or shrunken. •This serosa also shows evidence of prior inflammatory processes in the form of fibrin or fibrous deposition. •The wall is often thickened 2-3 times normal size.
CHRONIC CHOLECYSTITIS • General Micro Description•Microscopically, the walls shows involvement of chronic inflammation in the form of macrophages, lymphocytes and plasma cells. •Outpouchings of the mucosa through the muscle of the gall bladder wall (Rokitansky - Aschoff Sinuses) are a characteristic, but not diagnostic, feature of chronic cholecystitis
