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Arch Surg. 2008;143(11):1130.

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Answer: Diffuse Adenomyomatosis of the Gallbladder

The "necklace appearance" of the mass was more clearly demonstrated on magnetic resonance imaging, representing bile in the Rokitansky-Aschoff sinuses. The gallbladder lumen was narrowed because of the hypertrophic mucosa and muscular wall. The bile was hyperintense on T1- and T2-weighted images. Diffuse adenomyomatosis of the gallbladder was indicated, but occult gallbladder cancer could not be excluded. A 9 x 6 x 4-cm pink gallbladder mass was resected. Narrowed lumen (7 x 1 x 0.7 cm) was apparent (Figure 2). Adenomyomatosis was diagnosed microscopically. There was no evidence of gallbladder cancer.

Figure appears in full text version. Figure 2. Photograph of the gross pathologic specimen obtained by cholecystectomy reveals hypertrophy of the muscular wall (*) and narrowing of the lumen (L).

Adenomyomatosis of the gallbladder is a relatively common disease that is found in 2% to 5% of specimens obtained at cholecystectomy.¹ Pathologically, it is defined by epithelial proliferation and hypertrophy of the muscularis . . . [Full Text of this Article]

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Arch Surg. 2008;143(11):1129.
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