Hepatobiliary and pancreatic surgery: adenomyomatosis of the gallbladder: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Hepatobiliary and pancreatic surgery: adenomyomatosis of the gallbladder

Sample item

Ultrasound of a 50-year-old woman with vague dyspepsia shows focal thickening of the gallbladder fundal wall with small intramural cystic spaces and bright comet-tail echoes. There are no stones and the wall mucosa is regular. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Adenomyomatosis

Adenomyomatosis is a benign hyperplastic condition in which epithelium herniates into a thickened muscle layer, forming Rokitansky-Aschoff sinuses that trap cholesterol crystals and give comet-tail artefacts. It needs no treatment unless symptomatic.

Option by option

  • A. Xanthogranulomatous cholecystitis

    Xanthogranulomatous disease causes marked inflammatory thickening with hypoechoic nodules and usually stones.

  • B. Adenomyomatosis (correct)

    Correct. Wall thickening with intramural sinuses and comet-tail artefacts is characteristic.

  • C. Gallbladder carcinoma

    Carcinoma would show an irregular mass or invasion of the liver.

  • D. Cholesterolosis

    Cholesterolosis shows lipid-laden macrophages in the mucosa and typically causes no wall thickening.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Adenomyomatosis. Adenomyomatosis is a benign hyperplastic condition in which epithelium herniates into a thickened muscle layer, forming Rokitansky-Aschoff sinuses that trap cholesterol crystals and give comet-tail artefacts.

Why is "Xanthogranulomatous cholecystitis" not the answer?

Xanthogranulomatous disease causes marked inflammatory thickening with hypoechoic nodules and usually stones.

Why is "Gallbladder carcinoma" not the answer?

Carcinoma would show an irregular mass or invasion of the liver.

Why is "Cholesterolosis" not the answer?

Cholesterolosis shows lipid-laden macrophages in the mucosa and typically causes no wall thickening.

What concept does this question test?

It tests Hepatobiliary and pancreatic surgery: adenomyomatosis of the gallbladder in General Surgery. It needs no treatment unless symptomatic.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hepatobiliary and pancreatic surgery: adenomyomatosis of the gallbladder?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.