Segmental type of gallbladder adenomyomatosis – Case report and literature review
More details
Hide details
Department of Diagnostic Imaging, SP ZOZ MSW with Warmia and Mazury Oncology Center, Olsztyn, Poland
Department of Radiology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
Department of Anatomy, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
Department of Radiology, Military Institute of Aviation Medicine in Warsaw, Poland
Department of Surgery, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
Department of Pathomorphology, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, Poland
Submission date: 2014-07-04
Acceptance date: 2015-03-12
Online publication date: 2015-04-28
Publication date: 2020-03-24
Corresponding author
Maciej Michalak   

Al. Wojska Polskiego 37, 10-228 Olsztyn, Poland. Tel.: +48 604 239 126.
Pol. Ann. Med. 2015;22(1):55-58
Adenomyomatosis of the gallbladder is a benign mural disorder characterized by a thickened wall, proliferation and distention of Rokitansky–Aschoff sinuses surrounded by proliferated fibromuscular tissue.

Overview of radiological imaging methods used to evaluate the segmental type of adenomyomatosis of the gallbladder.

Case study:
The patient was admitted to the Emergency Department with typical symptoms of hepatic colic. Ultrasonography did not allow the exclusion of gallbladder cancer and diagnosis required clarification in Multidetector CT and MR with MR cholangiopancreatography. The surgical pathological specimen revealed segmental form of adenomyomatosis with cholelithiasis and chronic inflammation.

Results and discussion:
Adenomyomatosis is not considered a pre-cancerous condition, but elevated intraluminal pressure, gallstones and chronic inflammation are risk factors for gallbladder cancer. The most common imaging methods used to diagnose adenomyomatosis of gallbladder are US and MRI with MRCP.

The segmental type of gallbladder adenomyomatosis with a tendency of cholelithiasis, and higher risk of gallbladder malignancies, is a direct recommendation for cholecystectomy. Despite improvements of diagnostic imaging methods differentiation of segmental adenomyomatosis from early gallbladder cancer still remains challenging.

None declared.
Yoon JH, Cha SS, Han SS, Lee SJ, Kang MS. Gallbladder adenomyomatosis: imaging findings. Abdom Imaging. 2006;31(5):555–563.
Catalano OA, Sahani DV, Kalva SP, et al. MR imaging of the gallbladder: a pictorial essay. Radiographics. 2008;28(1):135–155.
Basaranoglu M, Balci NC. A true fundic diverticulum of the gallbladder. J Gastroenterol Hepatol. 2006;21(7):1222–1223.
Nishimura A, Shirai Y, Hatakeyama K. Segmental adenomyomatosis of the gallbladder predisposes to cholecystolithiasis. J Hepatobiliary Pancreat Surg. 2004;11(5):342–347.
Kai K, Ide T, Masuda M, et al. Clinicopathologic features of advanced gallbladder cancer associated with adenomyomatosis. Virchows Arch. 2011;459(6):573–580.
Joo I, Lee JY, Kim JH, et al. Differentiation of adenomyomatosis of the gallbladder from early-stage, wall- thickening-type gallbladder cancer using high-resolution ultrasound. Eur Radiol. 2013;23(3):730–738.
Yu MH, Lee JY, Yoon JH, Baek JH, Han JK, Choi BI. Color Doppler twinkling artifacts from gallbladder adenomyomatosis with 1.8 MHz and 4.0 MHz color Doppler frequencies. Ultrasound Med Biol. 2012;38(7):1188–1194.
Kim MJ, Oh YT, Park YN, et al. Gallbladder adenomyomatosis: findings on MRI. Abdom Imaging. 1999;24(4):410–413.
Haradome H, Ichikawa T, Sou H, et al. The pearl necklace sign: an imaging sign of adenomyomatosis of the gallbladder at MR cholangiopancreatography. Radiology. 2003;227(1):80–88.
Ogawa T, Horaguchi J, Fujita N, et al. High b-value diffusion- weighted magnetic resonance imaging for gallbladder lesions: differentiation between benignity and malignancy. J Gastroenterol. 2012;47(12):1352–1360.
Ching BH, Yeh BM, Westphalen AC, Joe BN, Qayyum A, Coakley FV. CT differentiation of adenomyomatosis and gallbladder cancer. AJR Am J Roentgenol. 2007;189(1):62–66.
Boscak AR, Al-Hawary M, Ramsburgh SR. Best cases from the AFIP: adenomyomatosis of the gallbladder. Radiographics. 2006;26(3):941–946.
Maldjian PD, Ghesani N, Ahmed S, Liu Y. Adenomyomatosis of the gallbladder: another cause for a ‘‘hot’’ gallbladder on 18F-FDG PET. AJR Am J Roentgenol. 2007;189(1):36–38.
Suzuki K, Watada S, Yoko M, Nakahara T, Kumamoto Y. Successful diagnosis of gallbladder carcinoma coexisting with adenomyomatosis by 18F-FDG-PET – report of a case. J Gastrointest Cancer. 2011;42(4):252–256.
Pellino G, Sciaudone G, Candilio G, et al. Stepwise approach and surgery for gallbladder adenomyomatosis: a minireview. Hepatobiliary Pancreat Dis Int. 2013;12(2):136–142.
Cho JY, Han HS, Yoon YS, Ahn KS, Kim YH, Lee KH. Laparoscopic approach for suspected early-stage gallbladder carcinoma. Arch Surg. 2010;145(2):128–133.
Journals System - logo
Scroll to top