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June 12, 1937


JAMA. 1937;108(24):2042-2043. doi:10.1001/jama.1937.02780240034012

Virchow in 1857 described a peculiar stippled appearance of the mucosa of some gallbladders removed during necropsies. He regarded the yellow flecks and strands as fatty infiltration and suggested that the material is a neutral fat excreted by the liver and reabsorbed from the bile by the epithelial cells of the gallbladder mucosa. The condition received scanty attention from surgeons and pathologists, despite its not infrequent occurrence and a striking gross appearance.

Aschoff1 demonstrated in 1906 the occurrence of cholesterol in the epithelial cells of the mucous membrane of the gallbladder. Moynihan2 in 1909 presented an excellent description of the naked eye appearance of cholesterosis, calling attention to the yellow stippling of the mucosa. He regarded the discoloration as the result of an inflammatory process in which the epithelium was desquamated and the underlying tissue became bile stained. In six of his cases of this type, relief from

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