More Than Just Stones: A Pictorial Review of Common and Less Common Gallbladder Pathologies

The Gallbladder

“…The most specifi c CT fi nding is a hypodense band in the gallbladder wall, found in one-third of patients [ 35 ]. On MRI, the wall may appear to contain focal or diffuse areas of high T2 and low T1 signal, which shows delayed enhancement with gadolinium [ 14 ]. Rarely, xanthogranulomatous cholecystitis may present as an intraluminal mass and mimic a neoplasm.…”

“…Although gallbladder wall thickening appears in many diseases, wall thickening greater than 10 mm with associated mucosal irregularity or marked asymmetry suggests a tumor [ 14 ].…”

“…The incidence increases with age. Adenomyomatosis can manifest as focal (usually affecting the fundus), segmental (such as an annular confi guration resulting in an "hourglass"), or diffuse gallbladder wall thickening [ 14 ]. As it may mimic other more serious gallbladder pathology, such as gallbladder carcinoma, radiologists should familiarize themselves with its imaging features.…”

“…They are more commonly found in women and may be associated with PeutzJeghers or familial polyposis syndromes [ 14 ]. They are usually solitary (90 %) and may be sessile or pedunculated [ 15 ] Cholesterolosis, an accumulation of lipid-laden macrophages in the lamina propria of the gallbladder, may result in the formation of excrescences called cholesterol polyps.…”

Biliary

“…Polyps of the gallbladder are observed in about 5 % of patients that undergo an abdominal ultrasound [ 133 ] with most patients being asymptomatic (77 %) [ 134 ] and imaged for another reason. The majority of these documented polyps are pseudopolyps with the majority being cholesterol polyps or adenomyomatosis (85 %) followed by infl ammatory polyps (10 %) with the remainder being true polyps that are predominantly either adenomas or adenocarcinomas [ 135 ].…”