Pathology dictionary

What is a cholesterol cleft?

A cholesterol cleft is a small open space filled with a type of fat called cholesterol. Cholesterol clefts can only be seen under the microscope.

Our body is made up of trillions cells. Each cell is like a tiny water filled bag with an outer wall that surrounds the soft parts inside. The cell wall is made up of proteins, sugars, and fat.

One of these fats is called cholesterol. When cells become damaged or break down, the cholesterol in the cell wall is released into the tissue surrounding the cell. Once in the tissue, cholesterol tends to clump together to form little droplets that pathologists call cholesterol clefts.

When viewed under the microscope, cholesterol clefts look like small open spaces.

Because these cholesterol clefts are abnormal, the body attempts to remove them with the help of a special type of immune cell called a macrophages. Sometimes, the macrophages join to form extra large cells called multi-nucleated giant cells which are specially designed to remove abnormal material like cholesterol clefts.

Because cholesterol clefts form anytime cells become damaged or break down, they can be seen in a variety of different situations including:

  • After trauma or a surgical procedure.
  • In conditions associated with chronic inflammation.
  • Inside a cyst, especially if it is large or has been there for a long time.
  • Some tumours contain lots of cholesterol clefts.

For this reason, a cholesterol cleft is a descriptive term and not a diagnosis.

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