Focal diffuse gall bladder wall thickening with comet tail reverberation aifacts on USG is in ?
Ans is `a' i.e., Adenomyomatosis of gall bladderCholecystoses o Cholecystoses are a group of noninflammatory conditions of gallbladder wall. cholecystoses can be divided into hyperplastic and thesaurismotic (accumulating forms). The hyperplastic forms are characterized by normal growth of the wall components, while thesaurismotic forms accumulate deposite of organic and inorganic material in the gall bladder wall.o The common forms of cholecystoses are Adenomyomatosis, cholesterosis and porcelain gall bladder. 1)Adenomyomatosis : - Ademomyomatosis is the most common form of cholecystoses. It is characterized by segmental or diffuse thickening of mucosa and muscular wall . In the thickened wall, more specifically, small cystic spaces are present, representing the dilated Rokitansky-Aschoff sinus. The most frequent site of the segment form is the gall bladder fundus. The sonographic signs are an irregular profile of the internal mucosa and wall thickening, in which may be seen hypoechoic cyst like zones corresponding to RokitanskyAschoff sinuses. These cystic zones may contain debris or little stones, have an acoustic shadow or, more frequently, a comet tail aefact, which is considered a specific finding. USG findings in brief are : -i) Hyperechoic thickening of bladder wall.ii) Hypoechoic cyst in the walliii) Acoustic shadowiv) Coment tail aefact2)Cholesterosis : - There are deposits of cholesterol in the epithelial cells and in the submucosal macrophages. This gives appearance of multiple small yellow spots on a red hyperplastic muscosa, the straberry gallbladder. Cholesterosis may be : -i) Diffuse & micronodular (Nodule < 1 mm)Focal (nodules > 3 mm)3) Porcelain gallbladder : - Consists of calcification of gall bladder wall; the calcified wall produces shadowing of the acoustic signal.
Adenomyomatosis of gall bladder
Ca gall bladder
Adenomatous polyps
Xantho granuloma