Gallbladder
Miscellaneous nontumor
Adenomyomatous hyperplasia

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 5 February 2018, last major update September 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Adenomyomatous hyperplasia gallbladder

Cite this page: Gulwani, H. Adenomyomatous hyperplasia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/gallbladderadenomyomatous.html. Accessed June 18th, 2018.
Definition / general
  • Also called adenomyomatosis, diverticular disease of gallbladder
  • Benign
  • Usually asymptomatic
  • Relatively common (9% of cholecystectomy specimens)
  • 80% associated with chronic cholecystitis
  • Rarely associated with dysplasia and carcinoma
Terminology
  • Generalized, segmental or localized types
    • Generalized:
      • Diffuse wall thickening (up to 5x normal) with intramural diverticula resembling cystic spaces within the wall
    • Segmental:
      • Focal thickening in gallbladder wall, usually body, giving it an hourglass configuration
    • Localized:
      • Fundus has nodules from 0.5 to 2.5 cm with grayish white cut surface containing multiple cysts
      • May cause gallbladder inversion
      • Also called adenomyoma
Case reports
Gross images

Images hosted on other servers:

Various images

Microscopic (histologic) description
  • Two types:
    1. Numerous Rokitansky-Aschoff sinuses accompanied by smooth muscle hyperplasia and expanded subserosal layer containing numerous nerve trunks
    2. Extensively fibrotic gallbladder wall with numerous Rokitansky-Aschoff sinuses but few / no smooth muscle bundles and an expanded subserosal layer containing abundant nerve trunks; surface epithelium may be papillary
  • May have reactive epithelial changes and metaplasia
  • Rarely has perineural and intraneural invasion only in the subserosal layer (benign gland-like structures may migrate into nerves due to chemotactic factors or signaling substances with activation of cell receptors, Am J Surg Pathol 2007;31:1598)
Microscopic (histologic) images

Images hosted on other servers:

Various images

Differential diagnosis