International journal of surgery case reports · 2026
Cholesterolosis mimicking gallbladder adenomyomatosis on imaging in an asymptomatic patient with concurrent cholelithiasis: a case report.
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Al-Olayan Hayfa A
Аннотация
BACKGROUND: Gallbladder cholesterolosis and adenomyomatosis (GA) share overlapping cross-sectional imaging features on CT enterography and MRCP, creating a significant diagnostic pitfall. Histopathology remains the only definitive means of distinction.
CASE PRESENTATION: A 44-year-old asymptomatic female was incidentally found to have gallbladder wall thickening and cholelithiasis on CT enterography. MRI/MRCP demonstrated focal fundal wall thickening with intramural high-signal foci, which was interpreted as fundal-type GA with a coexisting gallstone. Elective laparoscopic cholecystectomy was performed. Histopathology revealed chronic cholecystitis with focal cholesterolosis - no adenomyomatosis or Rokitansky-Aschoff sinuses were identified.
CONCLUSION: Cholesterolosis can produce imaging features indistinguishable from fundal-type GA. Elective laparoscopic cholecystectomy provides definitive treatment of concurrent cholelithiasis and the histopathological confirmation needed to resolve diagnostic uncertainty.
CASE PRESENTATION: A 44-year-old asymptomatic female was incidentally found to have gallbladder wall thickening and cholelithiasis on CT enterography. MRI/MRCP demonstrated focal fundal wall thickening with intramural high-signal foci, which was interpreted as fundal-type GA with a coexisting gallstone. Elective laparoscopic cholecystectomy was performed. Histopathology revealed chronic cholecystitis with focal cholesterolosis - no adenomyomatosis or Rokitansky-Aschoff sinuses were identified.
CONCLUSION: Cholesterolosis can produce imaging features indistinguishable from fundal-type GA. Elective laparoscopic cholecystectomy provides definitive treatment of concurrent cholelithiasis and the histopathological confirmation needed to resolve diagnostic uncertainty.