September 24, 2023

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.

Where do cholesterol clefts come from?

Our body is made up of trillions of 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.

What do cholesterol clefts look like under the microscope?

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 an immune cell called a histiocyte. Sometimes, the histiocytes will join to form extra-large cells called multi-nucleated giant cells which are specially designed to remove abnormal material like cholesterol clefts.

What causes cholesterol clefts to form?

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.

About this article

Doctors wrote this article to help you read and understand your pathology report. Contact us if you have questions about this article or your pathology report. For a complete introduction to your pathology report, read this article.

Other helpful resources

Atlas of pathology