On abdominal ultrasound gallbladder shows diffuse wall thickening with hyperechoic nodules at neck and comet tail aifacts. The most likely diagnosis will be:
Adenomyomatosis
Adenocarcinoma of gallbladder
Xanthogranulomatous cholecystitis
Cholesterol crystals
Ans.A. AdenomyomatosisAdenomyomatosis is a benign condition characterized by hyperplastic changes of unknown etiology involving the GB wall.It causes overgrowth of the mucosa, thickening of muscular wall, and formation of intramural diveicula or sinus tracts termed as Aschoff-Rokitansky sinuses.Investigations-USG- The presence of cholesterol crystals in these sinuses can result in "diamond ring sign", "V-shaped", or "comet-tail" aifacts on USG.Treatment- Cholecystectomy is indicated in symptomatic adenomyomatosis or when cholelithiasis is present.