Porcelain Gallbladder: Porcelain gallbladder refers to intramural dystrophic calcification of the gallbladder wall. One setting that may give rise to this condition is leakage of bile into subepithelial tissues through ulcers or fissures produced by gallstones. Bile incites a histiocytic reaction that is often followed by a reparative response consisting of dense fibrosis and dystrophic calcification. If the calcification is widespread, the gallbladder wall becomes stiff, non-pliant shell - referred to as porcelain gallbladder. In this image, the mucosa is shaggy and there is thickening of the wall. The yellow, discontinuous layer along the lumen is calcification. Image courtesy of: Dr. Ibrahim Zardawi; used with permission.