This case shows abnormalities of the gallbladder in keeping with adenomyomatosis. The patient was submitted to cholecystectomy.

MACROSCOPIC DESCRIPTION: "Gallbladder": An intact gallbladder measuring 110x35mm. The cystic duct is 3x3mm. The serosa appears diffusely congested. The maximum thickness of gallbladder wall is 13mm. The mucosa wall is diffusely congested and indurated. There is a focal area of nodularity spanning 20mm and is approximately 50mm from the cystic duct margin. The gallbladder lumen has two gallstones, each measuring 10mm.

MICROSCOPIC DESCRIPTION: Sections of the gallbladder wall show patchy mucosal ulceration. The intact areas show mucosal lining, which shows mild reactive atypia. The gallbladder wall is thickened, hemorrhagic, edematous and acutely inflamed. Occasional Rokitansky Aschoff sinuses are seen. Reactive peribiliary glands are present. There is no evidence of dysplasia or invasive malignancy.

DIAGNOSIS: Gallbladder: Acute on chronic cholecystitis; adenomyomata. No evidence of dysplasia or invasive malignancy identified.

Case courtesy of Dr Beng Ghee Lim and The Royal Melbourne Hospital Pathology department.