Adenomyomatosis

Adenomyomatosis, also known as adenomyoma or adenomyomatous hyperplasia of the gallbladder, is one of the two hyperplastic cholecystoses. The other hyperplastic cholecystosis is cholesterolosis, or "strawberry gallbladder." Adenomyomatosis is a benign condition that is pathologically characterized by hyperplasia of the gallbladder wall mucosa and muscularis propria, with pathognomonic epithelial invaginations forming cystic pockets (Rokitansky-Aschoff sinuses). These sinuses may contain calculi or cholesterol crystals. The gallbladder wall thickening, Rokitansky-Aschoff sinuses, and the calculi or cholesterol crystals often found in sinuses characterize the imaging appearance of adenomyomatosis. Sometimes, mainly when the characteristic imaging findings are absent, adenomyomatosis can be challenging to distinguish from gallbladder cancer based on the diagnostic imaging findings. Adenomyomatosis is often asymptomatic and incidentally detected, requiring no specific treatment. Adenomyomatosis also can be associated with right upper quadrant pain. In cases where it is challenging to distinguish adenomyomatosis from gallbladder cancer or when adenomyomatosis is associated with right upper quadrant pain, this condition may be treated with cholecystectomy.