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Hyperplastic Cholecystosis (Adenomyomatosis)
Maria A. Manning, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Adenomyomatous hyperplasia, diverticular disease of gallbladder (GB)
            • Definitions

              • Generic term for nonneoplastic, noninflammatory proliferative disorders of GB wall
                • Cholesterolosis: Abnormal deposits of triglycerides and cholesterol esters in subepithelium of GB
                • Adenomyomatosis: Focal or segmental GB wall thickening due to mucosal proliferation and hypertrophy of muscularis with invagination of excess mucosa into thickened muscularis- forming Rokitansky-Aschoff (RA) sinuses
                  • These sinuses can contain bile, cholesterol crystals, sludge, and calculi
              • Although classified together, cholesterolosis and adenomyomatosis have different etiology and clinical features, and should be considered separate entities

            IMAGING

            • General Features

              • Ultrasonographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Revzin MV et al: The gallbladder: uncommon gallbladder conditions and unusual presentations of the common gallbladder pathological processes. Abdom Imaging. Epub ahead of print, 2014
                                          2. Runner GJ et al: Gallbladder wall thickening. AJR Am J Roentgenol. 202(1):W1-W12, 2014
                                          3. Pellino G et al: Stepwise approach and surgery for gallbladder adenomyomatosis: a mini-review. Hepatobiliary Pancreat Dis Int. 12(2):136-42, 2013
                                          4. Meacock LM et al: Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound. Br J Radiol. 83(991):615-27, 2010
                                          5. Ash-Miles J et al: More than just stones: a pictorial review of common and less common gallbladder pathologies. Curr Probl Diagn Radiol. 37(5):189-202, 2008
                                          6. Catalano OA et al: MR imaging of the gallbladder: a pictorial essay. Radiographics. 28(1):135-55; quiz 324, 2008
                                          7. Stunell H et al: Imaging of adenomyomatosis of the gall bladder. J Med Imaging Radiat Oncol. 52(2):109-17, 2008
                                          8. van Breda Vriesman AC et al: Diffuse gallbladder wall thickening: differential diagnosis. AJR Am J Roentgenol. 188(2):495-501, 2007
                                          9. Boscak AR et al: Best cases from the AFIP: adenomyomatosis of the gallbladder. Radiographics. 26(3):941-6, 2006
                                          10. Lack E et al: Pathology of the Pancreas, Gallbladder, Extrahepatic Biliary Tract, and Ampullary Region. Oxford New York: Oxford University Press. 427-9, 2003
                                          11. Owen CC et al: Gallbladder polyps, cholesterolosis, adenomyomatosis, and acute acalculous cholecystitis. Semin Gastrointest Dis. 14(4):178-88, 2003
                                          12. Gore RM et al: Imaging benign and malignant disease of the gallbladder. Radiol Clin North Am. 40(6):1307-23, vi, 2002
                                          13. Levy AD et al: Benign tumors and tumorlike lesions of the gallbladder and extrahepatic bile ducts: Radiologic-pathologic correlation. RadioGraphics. 22: 387-413, 2002
                                          14. Berk RN et al: The hyperplastic cholecystoses: cholesterolosis and adenomyomatosis. Radiology. 146(3):593-601, 1983
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Adenomyomatous hyperplasia, diverticular disease of gallbladder (GB)
                                                    • Definitions

                                                      • Generic term for nonneoplastic, noninflammatory proliferative disorders of GB wall
                                                        • Cholesterolosis: Abnormal deposits of triglycerides and cholesterol esters in subepithelium of GB
                                                        • Adenomyomatosis: Focal or segmental GB wall thickening due to mucosal proliferation and hypertrophy of muscularis with invagination of excess mucosa into thickened muscularis- forming Rokitansky-Aschoff (RA) sinuses
                                                          • These sinuses can contain bile, cholesterol crystals, sludge, and calculi
                                                      • Although classified together, cholesterolosis and adenomyomatosis have different etiology and clinical features, and should be considered separate entities

                                                    IMAGING

                                                    • General Features

                                                      • Ultrasonographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Revzin MV et al: The gallbladder: uncommon gallbladder conditions and unusual presentations of the common gallbladder pathological processes. Abdom Imaging. Epub ahead of print, 2014
                                                                                  2. Runner GJ et al: Gallbladder wall thickening. AJR Am J Roentgenol. 202(1):W1-W12, 2014
                                                                                  3. Pellino G et al: Stepwise approach and surgery for gallbladder adenomyomatosis: a mini-review. Hepatobiliary Pancreat Dis Int. 12(2):136-42, 2013
                                                                                  4. Meacock LM et al: Evaluation of gallbladder and biliary duct disease using microbubble contrast-enhanced ultrasound. Br J Radiol. 83(991):615-27, 2010
                                                                                  5. Ash-Miles J et al: More than just stones: a pictorial review of common and less common gallbladder pathologies. Curr Probl Diagn Radiol. 37(5):189-202, 2008
                                                                                  6. Catalano OA et al: MR imaging of the gallbladder: a pictorial essay. Radiographics. 28(1):135-55; quiz 324, 2008
                                                                                  7. Stunell H et al: Imaging of adenomyomatosis of the gall bladder. J Med Imaging Radiat Oncol. 52(2):109-17, 2008
                                                                                  8. van Breda Vriesman AC et al: Diffuse gallbladder wall thickening: differential diagnosis. AJR Am J Roentgenol. 188(2):495-501, 2007
                                                                                  9. Boscak AR et al: Best cases from the AFIP: adenomyomatosis of the gallbladder. Radiographics. 26(3):941-6, 2006
                                                                                  10. Lack E et al: Pathology of the Pancreas, Gallbladder, Extrahepatic Biliary Tract, and Ampullary Region. Oxford New York: Oxford University Press. 427-9, 2003
                                                                                  11. Owen CC et al: Gallbladder polyps, cholesterolosis, adenomyomatosis, and acute acalculous cholecystitis. Semin Gastrointest Dis. 14(4):178-88, 2003
                                                                                  12. Gore RM et al: Imaging benign and malignant disease of the gallbladder. Radiol Clin North Am. 40(6):1307-23, vi, 2002
                                                                                  13. Levy AD et al: Benign tumors and tumorlike lesions of the gallbladder and extrahepatic bile ducts: Radiologic-pathologic correlation. RadioGraphics. 22: 387-413, 2002
                                                                                  14. Berk RN et al: The hyperplastic cholecystoses: cholesterolosis and adenomyomatosis. Radiology. 146(3):593-601, 1983