What histologic features are typical of chronic cholecystitis?

What histologic features are typical of chronic cholecystitis?

• A. Thickened gallbladder wall without gallstones
• B. Gallstones with no inflammation
• C. Rokitansky-Aschoff sinuses without chronic inflammation
• D. Thickened gallbladder wall with Rokitansky-Aschoff sinuses and gallstones; chronic inflammatory infiltrate

Answer: (D)

Chronic cholecystitis is defined by long-standing inflammation of the gallbladder with scarring. The characteristic histology shows a thickened gallbladder wall due to fibrotic and muscular changes from repeated inflammatory insults, along with a chronic inflammatory infiltrate rich in lymphocytes and plasma cells. Gallstones commonly accompany this process, serving as a persistent irritant that drives ongoing inflammation and fibrosis. Rokitansky-Aschoff sinuses—mucosal outpouchings that extend into the muscular layer—are a classic sign of chronicity, reflecting mucosal herniation through a thickened wall in the setting of chronic inflammation. When these elements occur together—the thickened wall, Rokitansky-Aschoff sinuses, gallstones, and chronic inflammatory infiltrate—the pattern is most consistent with chronic cholecystitis. If gallstones are present without inflammation, or if sinuses appear without accompanying chronic inflammation, those scenarios are less characteristic of chronic cholecystitis.

Chronic cholecystitis is defined by long-standing inflammation of the gallbladder with scarring. The characteristic histology shows a thickened gallbladder wall due to fibrotic and muscular changes from repeated inflammatory insults, along with a chronic inflammatory infiltrate rich in lymphocytes and plasma cells. Gallstones commonly accompany this process, serving as a persistent irritant that drives ongoing inflammation and fibrosis. Rokitansky-Aschoff sinuses—mucosal outpouchings that extend into the muscular layer—are a classic sign of chronicity, reflecting mucosal herniation through a thickened wall in the setting of chronic inflammation. When these elements occur together—the thickened wall, Rokitansky-Aschoff sinuses, gallstones, and chronic inflammatory infiltrate—the pattern is most consistent with chronic cholecystitis. If gallstones are present without inflammation, or if sinuses appear without accompanying chronic inflammation, those scenarios are less characteristic of chronic cholecystitis.