The hyperplastic cholecystoses: cholesterolosis and adenomyomatosis.

Abstract

Cholesterolosis and adenomyomatosis, two diseases of the gallbladder that are unrelated to cholelithiasis or cholecystitis, are detected on oral cholecystograms with considerable frequency. These disorders are of uncertain etiology, and it is also unclear if they cause clinical symptoms. Cholesterolosis is the result of the accumulation of triglycerides and esterified sterols in macrophages in the lamina propria. The abnormality is unassociated with cholesterol gallstones, supersaturation of bile with cholesterol, hyperlipidemia, obesity, or atherosclerosis. Adenomyomatosis involves hyperplasia of the tissues of the gallbladder wall with outpouches of the mucosa similar to diverticula of the colon. In this report, the pathology, etiology, clinical and radiologic features, and treatment of these two entities are reviewed.

Cholecystokinetic cholecystography

“…We therefore agree with Berk et al [13] that the exaggerated rate of gallbladder emptying in case of a hyperplastic cholecystosis is still debatable. The need for added x-ray exposure with a postcontraction examination remains debatable too, which is another reason to doubt the diagnostic value of gallbladder contraction.…”

Differential diagnosis of gallbladder cancer using positron emission tomography with fluorine‐18‐labeled fluoro‐deoxyglucose (FDG‐PET)

“…Adenomyomatosis of the gallbladder is a common disease that usually presents as a focal lesion or as a diffuse wall thickening of the gallbladder, and therefore differentiating it from gallbladder carcinoma is important [24]. The value of the Rokitansky-Aschoff sinuses in the diagnosis of adenomyomatosis has been suggested on transabdominal sonography, CT, and MR imaging [25][26][27]. However, with these conventional imaging modalities, the differential diagnosis from gallbladder carcinoma is often difficult to make.…”

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

“…Pathological [1][2][3] and radiological [1][2][3][4][5] findings in adenomyomatosis of the gallbladder have been previously reported. Pathologically, the amount of subserosal fat surrounding the normal gallbladder is quite variable [6].…”

“…In adenomyomatosis of the gallbladder, oral cholecystography shows contrast-filled gallbladder with intramural diverticula [ 1,2]. Ultrasonography shows thickening of the gallbladder wall and intramural diverticula, seen as anechoic or echogenic foci within the wall [1,3,4].…”

“…Ultrasonography shows thickening of the gallbladder wall and intramural diverticula, seen as anechoic or echogenic foci within the wall [1,3,4]. Computed tomography shows dense soft tissue masses in the gallbladder fossa with a well-demarcated and distinct tumor-free space between the mass and the liver, and small intramural diverticula and stones [4,5].…”