Cholesterolosis mimicking gallbladder adenomyomatosis on imaging in an asymptomatic patient with concurrent cholelithiasis: a case report
Hayfa A. Al-OlayanBackground:
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.