Gallbladder Cholesterolosis

Longitudinal US image of the gallbladder demonstrates multiple tiny echogenic spots within the wall with comet-tail artifacts. No evidence of gallbladder wall thickening. 

Facts:

• Other names: cholesteatosis, strawberry gallbladder
• Common, degenerative, proliferative changes of gallbladder
• Usually in females during their 4th and 5th decades
• Usually asymptomatic
• Not associated with increased risk of malignancy, cholelithiasis or cholecystitis

Differentiation from Adenomyomatosis:

• May be difficult at times because they may coexist and are believed to be a continuum of same pathology
• In cholesterolosis, the gallbladder has normal size, shape, lumen and often normal wall thickness

Reference:

Schmidt G. Differential diagnosis in  ultrasound imaging: A teaching file, 2006