Contributor's comments: Cholesterolosis is a common finding in the gallbladder. It usually manifests grossly as "strawberry gallbadder", ie., flat orange yellow crisply defined flecks on the mucosal surface, often running in a linear pattern along the gallbladder mucosal ridges. Microscopically, these regions are made up of focal collections of foamy histiocytes similar to those seen in the current case. It has been suggested that cholesterolosis results from the absorption of excess cholesterol from supersaturated bile (1), and is seen most often in multiparous women (2). The reason for the uncommon polyploid varient seen in this case is not clear.
1. James M. Crawford, The Liver and the biliary tract, a chapter in Robbins Pathologic Basis of Disease, 5th Edition, 1994, Saunders, p. 893.
2. Juan Rosai, Gallbladder and extrahepatic bile ducts, a chapter in Ackerman's Surgical Pathology, 7th Edition, 1989, CV Mosby Company, p739.