Adenomyomatosis of the gallbladder with subserosal fatty proliferation: CT findings in two cases

Abstract

Adenomyomatosis of the gallbladder is frequently seen in ordinary operative specimens. Subserosal fat may proliferate in the presence of adenomyomatosis, but the amount of subserosal fat may be quite variable. Typical and atypical computed tomographic (CT) findings in two cases of adenomyomatosis with subserosal fatty proliferation of the gallbladder are presented. The thick fatty layer surrounding the thickened gallbladder wall with intramural diverticula and stones, typical of CT findings, was seen in one case, and fat interspersed in the periphery of the thickened gallbladder wall without intramural stones, atypical of CT findings, was seen in a second case.

Adenomyomatosis with Marked Subserosal Fibrosis and Lipomatosis of the Gallbladder: Mural Stratification Demonstrated with MR

“…1 Oral cholecystography may reveal RAS if it maintains a patent communication with the lumen and if the RAS are large enough to create visible collections of contrast material adjacent to the lumen of the opaciˆed gallbladder. 2,3 Ultrasound appearances of adenomyomatosis had also been well described, including multiple comet tail artifacts. 4 Recent advances of spatial and temporal resolution in CT have enabled visualization of RAS.…”

“…They also believed that seven speciˆc changes in Jutras' classiˆcation can overlap and have a common etiology. 2 Miyake et al reported subserosal fat proliferation in adenomyomatosis on CT. 3 The cause of fat deposition is unknown; such reports suggest that fat deposition or massiveˆbrosis in lamina propria can sometimes occur in patients with adenomyomatosis. The resected specimen had a thickˆbrous layer with inˆltration of a few small round cells just under the RAS.…”

“…However, abdominal pain without calculi is common in the relatively older reports. 2,3 It is believed that excessive intraluminal pressure plays a role. The cause of the abdominal pain in the present case remained unknown, but the symptom disappeared following the cholecystectomy.…”

Hyperplastic Lesions and Metaplastic Changes of the Gallbladder

“…1 and 2). Fundic adenomyomatosis can bulge with excessive subserosal fat tissue of the gallbladder, producing a mass lesion (Miyake et al 1992;Shimoji et al 2001).…”