The imaging features were strongly suggestive of neoplastic etiology for the gallbladder wall thickening. However, the clinical presentation went against the possibility of malignancy.
The patient underwent laproscoopy which confirmed the imaging findings with involvement of the hepatic flexure of the colon, gallbladder fundus, and omentum. No gallbladder calculus was found. Pathology revealed xanthogranulomatous cholecystitis.