American Board of Pathology (ABPath) Practice Test

Adenomyomatosis of the gallbladder is characterized by the presence of intramural cysts, which are small pockets or cyst-like spaces within the wall of the gallbladder. This condition usually results from hyperplastic changes in the gallbladder wall and is a benign process that can alter the architecture of the gallbladder. The appearance is often described as having a thickened wall, but it is the intramural cysts that are the hallmark finding upon sonographic examination. These cysts can give the gallbladder wall a characteristic appearance, often described as a “strawberry gallbladder” due to the echogenicity associated with the cysts and the smooth, thickened wall.

The presence of intramural cysts differentiates adenomyomatosis from other conditions that may also show gallbladder wall thickening, such as inflammatory processes, which do not typically exhibit the same cystic changes. Recognizing these cysts can help to distinguish adenomyomatosis from malignancy or other pathologies that could also affect gallbladder morphology.