Focal and diffuse thickening of the gall bladder with hyperechoic shadows with comet tail sign is seen in:
|A||Xantho granulomatous cholecystitis|
|C||Gall bladder polyp|
|D||Carcinoma gall bladder|
a. Focal and diffuse thickening of the GB with hyperechoic shadows with comet tail sign is seen in adenomyomatosis of GB.
b. Adenomyomatosis of the gallbladder is characterized by epithelial proliferation, muscular hypertrophia and intramural diverticula (Rokitansky-Aschoff sinuses), which may segmentally or diffusely involve of the gallbladder.
c. It is a benign condition that requires no specific treatment, occurring as an incidental finding in up to 9% of cholecystectomy specimens .
d. The sonographic finding of cholesterol crystals, shown as 'comet-tail' reverberation artifacts , within a thickened wall of the gallbladder strongly suggests this diagnosis.
e. Air may produce a similar artifact, however, patients with emphysematous cholecystitis are usually ill in contrast to those with adenomyomatosis.
f. MR imaging may be able to differentiate adenomyomatosis from gallbladder carcinoma by depicting Rokitansky-Aschoff sinuses