Hyalinising Cholecystitis: Clinicopathological Elucidation of an Uncommon Sclerohyaline Gall Bladder Lesion

Abstract Hyalinising cholecystitis (HC) is a rare and distinct variant of chronic cholecystitis characterised by extensive hyaline sclerosis of the gall bladder wall, often accompanied by variable degrees of calcification. Although uncommon, accounting for approximately 1.6% of cholecystectomy specimens, HC has gained clinical significance due to its reported association with gall bladder carcinoma and the diagnostic challenges it presents. The present study aims to describe the clinicopathological features of HC through a case series and to highlight its diagnostic importance. This retrospective study included five cases of HC identified among cholecystectomy specimens. Clinical details, gross findings and histopathological features were reviewed in each case. The patients demonstrated a marked female predominance with a female-to-male ratio of 4:1 and the mean age at presentation was 50 years. Gross examination revealed variable gall bladder wall thickness without any obvious mass lesion. Histopathological evaluation showed near-complete replacement of the gall bladder wall architecture by dense, paucicellular hyalinised fibrosis, consistent with the characteristic features of HC. Cholelithiasis was present in four cases, with three cases showing multiple gallstones and one case showing a single stone, while one case had no gallstones. HC remains an uncommon but clinically important entity because of its documented association with gall bladder carcinoma and the difficulty in detecting malignancy both radiologically and histologically. Therefore, awareness of this condition and meticulous histopathological examination with extensive sampling of cholecystectomy specimens are essential for accurate diagnosis and early detection of any associated malignancy.