Cholesterol crystal morphology in acalculous gallbladder disease

Kristin Landi, John Sinard, James M. Crawford, Mark Topazian

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: Biliary crystal morphology is best described in patients with gallbladder stones, but most patients undergoing bile collection for microscopy have a clinical diagnosis of acalculous gallbladder disease. We investigated the morphology of biliary crystals in such patients. Study: Bile was obtained for polarizing microscopy from fresh cholecystectomy specimens of patients with a clinical diagnosis of acalculous or calculous gallbladder disease. Slides for microscopy were prepared by touch contact with bile in freshly opened gallbladder specimens, and following aspiration of gallbladder bile through a 5-French cannula. Results: Bile was examined from five patients with a clinical diagnosis of acalculous gallbladder disease and five patients with known gallstones. Needle-like cholesterol crystals predominated in most patients without gallstones, whereas plate-like and dot-like crystals were more common in patients with gallstones. All three crystal types were seen in most patients. Crystal morphology was not affected by aspiration of bile through a 5-French cannula. Conclusions: Birefringent needles and dots should be recognized as cholesterol crystals during bile microscopy. These crystal morphologies may predominate in some patients with a clinical diagnosis of acalculous gallbladder disease.

Original languageEnglish (US)
Pages (from-to)364-366
Number of pages3
JournalJournal of clinical gastroenterology
Volume36
Issue number4
DOIs
StatePublished - Apr 1 2003

Keywords

  • Bile
  • Cholesterol
  • Crystallization
  • Gallbladder

ASJC Scopus subject areas

  • Gastroenterology

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