Rare inflammatory process causing focal or diffuse destruction of gallbladder (GB) wall with accumulation of lipid-laden macrophages, fibrous tissue, and acute and chronic inflammatory cells

Marked GB wall thickening

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  Intramural hypoechoic nodules or bands with continuous mucosa

  
  
  
  
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    Nodular areas of foamy inflammatory cells or necrosis/abscess

  
  

Gallstones in 80%

Absence of hepatic invasion or biliary dilatation when uncomplicated

Complications in 30%

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  Infiltrative form: GB fossa mass involving adjacent organs and surrounding fat/soft tissue obliterating normal margins, preoperative differentiation from carcinoma nearly impossible

  
  
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  Abscesses, fistula

GB carcinoma

Gangrenous cholecystitis

Hyperplastic cholecystoses

1-2% of cholecystectomy specimens

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  Adenocarcinoma seen in up to 10% of resected specimens

Mean age at presentation: 44-63 years; F > M

Symptoms of chronic cholecystitis most common, followed by symptoms of acute cholecystitis with leucocytosis

Less common presentation: Obstructive jaundice, cholangitis, palpable mass

Treatment: Open cholecystectomy

Look for intramural hypoechoic nodules and preservation of mucosal line, which favor this over carcinoma