The hyperplastic cholecystoses: cholesterolosis and adenomyomatosis

Cholesterolosis and adenomyomatosis, two diseases of the gallbladder that are unrelated to cholelithiasis or cholecystitis, are detected on oral cholecystograms with considerable frequency. These disorders are of uncertain etiology, and it is also unclear if they cause clinical symptoms. Cholesterolosis is the result of the accumulation of triglycerides and esterified sterols in macrophages in the lamina propria. The abnormality is unassociated with cholesterol gallstones, supersaturation of bile with cholesterol, hyperlipidemia, obesity, or atherosclerosis. Adenomyomatosis involves hyperplasia of the tissues of the gallbladder wall with outpouches of the mucosa similar to diverticula of the colon. In this report, the pathology, etiology, clinical and radiologic features, and treatment of these two entities are reviewed.