Adenomyomatosis of the Gall-bladder

Colquhoun, John

doi:10.1259/0007-1285-34-398-101

Cited by 53 publications

(12 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In scenario of diagnostic uncertainty, radical en bloc resection is advisable, if expertise is available [33]. Another such benign condition is adenomyomatosis of gall bladder which is pathologically defined as an epithelial proliferation and hypertrophy of the GB muscularis with an outpouching of the mucosa into the thickened muscular layer (Rokitansky-Aschoff sinus) [35,36]. Pathognomonic radiological findings of adenomyomatosis of gall bladder include intramural cyst within a thickened GB wall (Rokitansky-Aschoff sinus) and the presence of cholesterol crystals or stones deposited in the Rokitansky-Aschoff sinuses [37].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention

et al. 2015

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The excessive epithelial proliferation leads to epithelial infolding within the underlying muscular layer with subsequent formation of epithelium-lined diverticular pouches, the so-called Rokitansky–Aschoff sinuses (RAS; Fig. 1) [1–4]. The content of RAS consists of bile that may undergo progressive dehydration over time, leading to cholesterine crystal precipitation [5].…”

Section: Main Textmentioning

confidence: 99%

“…GA is frequently observed in cholecystectomy specimens, with a reported prevalence of 1–9% in pathology series [1, 4, 9, 13]. GA represents about 40% of benign gallbladder lesions [1, 4].…”

Section: Main Textmentioning

confidence: 99%

Gallbladder adenomyomatosis: imaging findings, tricks and pitfalls

et al. 2017

View full text Add to dashboard Cite

Gallbladder adenomyomatosis (GA) is a benign alteration of the gallbladder wall that can be found in up to 9% of patients. GA is characterized by a gallbladder wall thickening containing small bile-filled cystic spaces (i.e., the Rokitansky–Aschoff sinuses, RAS). The bile contained in RAS may undergo a progressive concentration process leading to crystal precipitation and calcification development. A correct characterization of GA is fundamental in order to avoid unnecessary cholecystectomies. Ultrasound (US) is the imaging modality of choice for diagnosing GA; the use of high-frequency probes and a precise focal depth adjustment enable correct identification and characterization of GA in the majority of cases. Contrast-enhanced ultrasound (CEUS) can be performed if RAS cannot be clearly identified at baseline US: RAS appear avascular at CEUS, independently from their content. Magnetic resonance imaging (MRI) should be reserved for cases that are unclear on US and CEUS. At MRI, RAS can be identified with extremely high sensitivity, but their signal intensity varies widely according to their content. Positron emission tomography (PET) may be helpful for excluding malignancy in selected cases. Computed tomography (CT) and cholangiography are not routinely indicated in the suspicion of GA.Teaching points1. Gallbladder adenomyomatosis is a common benign lesion (1–9% of the patients).2. Identification of Rokitansky–Aschoff sinuses is crucial for diagnosing gallbladder adenomyomatosis.3. Sonography is the imaging modality of choice for diagnosing gallbladder adenomyomatosis.4. Intravenous contrast material administration increases ultrasound accuracy in diagnosing gallbladder adenomyomatosis.5. Magnetic resonance is a problem-solving technique for unclear cases.

show abstract

“…Adenomyomatosis of the gallbladder (ADM) is defined as the epithelial proliferation and hypertrophy of the muscles of the gallbladder wall (1). An outpouching of the gallbladder mucosa into the thickened muscular layer is termed Rokitansky-Aschoff sinus (2).…”

Section: Introductionmentioning

confidence: 99%

Negative signals for adenomyomatosis of the gallbladder upon diffusion-weighted whole body imaging with background body signal suppression/T2-weighted image fusion analysis

Tomizawa

Shinozaki

Fugo

et al. 2016

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. Differentiation between adenomyomatosis (ADM) and cancer of the gallbladder is necessary during diagnosis. Diffusion-weighted whole body imaging with background body signal suppression (DWIBS) images are able to indicate cancer and inflammation. The fusion of a DWIBS with a T2 weighted image (DWIBS/T2) facilitates both functional and anatomical investigations. In the present study, patient records and images from patients with surgically confirmed ADM from April 2012 to October 2014 were analyzed retrospectively. The enrolled patients, including 6 men (64.2±13.1 years) and 4 women (57.3±12.4 years) were subjected to DWIBS/T2 during routine clinical practice. The diagnosis of ADM was based on magnetic resonance cholangiopancreatography, transabdominal ultrasonography, and endoscopic ultrasonography; ADM was diagnosed definitively when cystic lesions were observed, indicating the Rokitansky-Aschoff sinus. A single patient was indicated to be positive by DWIBS/T2 imaging. The Rokitansky-Aschoff sinus revealed a relatively high signal intensity; however, it was not as strong as that of the spleen. The signal intensity was also high on an apparent diffusion coefficient map, suggesting T2 shine-through. The thickened wall displayed low signal intensity. The aforementioned results indicate that ADM may be negative upon DWIBS/T2 imaging; one false positive case was determined to be ADM, accompanied by chronic cholecystitis. The majority of patients with ADM displayed negative findings upon DWIBS/T2 imaging, and chronic cholecystitis may cause false positives. IntroductionAdenomyomatosis of the gallbladder (ADM) is defined as the epithelial proliferation and hypertrophy of the muscles of the gallbladder wall (1). An outpouching of the gallbladder mucosa into the thickened muscular layer is termed Rokitansky-Aschoff sinus (2). ADM may be further divided into three subtypes: Fundal, segmental and diffuse (3). A major challenge in ADM diagnosis arises from the difficulty in distinguishing the disease from gallbladder cancer (4).Recent advances in diagnostic imaging have improved the distinction between ADM and gallbladder cancer. Contrast-enhanced endoscopic ultrasonography (EUS) is beneficial for the differential diagnosis of gallbladder wall thickening (5). High-resolution ultrasound is also advantageous for differentiating gallbladder cancers from ADM (6); however, the challenge of differentiating gallbladder cancer from ADM has yet to be resolved. A primary cause of the challenge is intratumoral cystic components, which create difficulty in discerning between gallbladder cancer and ADM (7).Diffusion-weighted whole body imaging with background body signal suppression (DWIBS) images are acquired through multiple-signal averaging, pre-pulse fat suppression, and heavy diffusion weighting during free breathing (8); DWIBS is based upon diffusion-weighted imaging (DWI), which visualizes and assesses the random movement of water at the molecular level (Brownian motion) (9,10). An advantage of DWIBS is that it provides...

show abstract

Adenomyomatosis of the Gall-bladder

Cited by 53 publications

References 5 publications

Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention

Laparoscopic radical cholecystectomy for suspected early gall bladder carcinoma: thinking beyond convention

Gallbladder adenomyomatosis: imaging findings, tricks and pitfalls

Negative signals for adenomyomatosis of the gallbladder upon diffusion-weighted whole body imaging with background body signal suppression/T2-weighted image fusion analysis

Contact Info

Product

Resources

About