Adenomyomatosis

WikiDoc Resources for Adenomyomatosis
Articles
Most recent articles on Adenomyomatosis Most cited articles on Adenomyomatosis Review articles on Adenomyomatosis Articles on Adenomyomatosis in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Adenomyomatosis Images of Adenomyomatosis Photos of Adenomyomatosis Podcasts & MP3s on Adenomyomatosis Videos on Adenomyomatosis
Evidence Based Medicine
Cochrane Collaboration on Adenomyomatosis Bandolier on Adenomyomatosis TRIP on Adenomyomatosis
Clinical Trials
Ongoing Trials on Adenomyomatosis at Clinical Trials.gov Trial results on Adenomyomatosis Clinical Trials on Adenomyomatosis at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Adenomyomatosis NICE Guidance on Adenomyomatosis NHS PRODIGY Guidance FDA on Adenomyomatosis CDC on Adenomyomatosis
Books
Books on Adenomyomatosis
News
Adenomyomatosis in the news Be alerted to news on Adenomyomatosis News trends on Adenomyomatosis
Commentary
Blogs on Adenomyomatosis
Definitions
Definitions of Adenomyomatosis
Patient Resources / Community
Patient resources on Adenomyomatosis Discussion groups on Adenomyomatosis Patient Handouts on Adenomyomatosis Directions to Hospitals Treating Adenomyomatosis Risk calculators and risk factors for Adenomyomatosis
Healthcare Provider Resources
Symptoms of Adenomyomatosis Causes & Risk Factors for Adenomyomatosis Diagnostic studies for Adenomyomatosis Treatment of Adenomyomatosis
Continuing Medical Education (CME)
CME Programs on Adenomyomatosis
International
Adenomyomatosis en Espanol Adenomyomatosis en Francais
Business
Adenomyomatosis in the Marketplace Patents on Adenomyomatosis
Experimental / Informatics
List of terms related to Adenomyomatosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Adenomyomatosis is a benign hyperplastic cholecystosis. It is a relatively common condition (identified in at least 5% of cholecystectomy specimens). Most diagnoses are made in patients in their 50s. Adenomyomatosis is most often an incidental finding, has no intrinsic malignant potential, and usually requires no treatment. Cholesterolosis, the other hyperplastic cholecystosis, consists of deposition of triglycerides and cholesterol esters within the lamina propria, producing a characteristic gross appearance known as "strawberry gallbladder." Cholesterol accumulation in adenomyomatosis is intraluminal, as cholesterol crystals precipitate in the bile trapped in Rokitansky-Aschoff sinuses (intramural diverticula lined by mucosal epithelium).

Classification

Gallbladder involvement by adenomyomatous hyperplasia is variable in extent and location, with heterogeneous imaging appearances corresponding to diffuse, segmental, and focal adenomyomatosis.

• • Exclusion of [gallbladder cancer] may be most problematic in segmental and focal cases
  • Focal adenomyomatosis may appear as a discrete mass, known as an adenomyoma.

Diagnosis

Ultrasound

• Echogenic intramural foci from which emanate V-shaped comet tail reverberation artifacts are highly specific for adenomyomatosis, representing the unique acoustic signature of cholesterol crystals within the lumina of Rokitansky-Aschoff sinuses.

Patient #1

• 
• 
• 
• 

CT

• Abnormal gallbladder wall thickening and enhancement are common but nonspecific CT features of adenomyomatosis.
• Rokitansky-Aschoff sinuses of sufficient size can be visualized; a CT rosary sign has been described, formed by enhancing epithelium within intramural diverticula surrounded by the relatively unenhanced hypertrophied gallbladder muscularis.

MRI

• The pearl necklace sign alludes to the characteristically curvilinear arrangement of multiple rounded hyperintense intraluminal cavities visualized at T2-weighted MR imaging and MR cholangiopancreatography of adenomyomatosis.

Patient #2: MRI images demonstrate adenomyomatosis at the gallbladder fundus

• 
  T2 SSFSE
• 
  T2 SSFSE
• 
  LAVA post GAD
• 
  T2 fat sat

Metabolic characterization with PET may be a useful adjunct in problematic cases.