[原著］Adenomyomatosis (Intramural Diverticulosis) of the Gallbladder : A Clinicopathological Study of 197 Cases

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One hundred and ninety-seven cases of adenomyomatosis of the gallbladder were clinicopathologically studied. Our histologic criterion for adenomyomatosis was based on a gallbladder wall thickness of greater than 3mm secondary to proliferation of 5 or more Rokitansky-Aschoff sinuses (RAS) per 1cm-length of the wall. Depending on the location of the lesion, adenomyomatosis was divided into four types : fundal, segmental, combined (fundal and segmental) and generalized. The incidence of this disease was 10.7% in a series of consecutive cholecystectomies. The average age at cholecystectomy was 52.1years. There was preponderance of male in a ratio of 1 to 0.88. The two commonest types were segmental and fundal, accounting for more than 80% of the disease. The average age in each type was similar. The overall incidence of associated gallstones and intramural calculi was 85.8% and 46.7%, respectively. Grossly, all types showed essentially a thickening of the involved wall with their own pathologic features. Histologically, they represented an identical proliferation of the RAS, a thickness of the muscularis and a frequent clustering of the epithelium. The two latter components, however, were not invariable.

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