Abstract
A 72-year-old man visited our hospital for follow-up after treatment with interferon for hepatitis C virus infection. Ultrasonography screening demonstrated wall thickening in the fundus of the gallbladder. Magnetic resonance cholangiopancreatography showed the pearl-necklace sign, typical of adenomyomatosis of the gallbladder. However, it was possible that cancer was associated with the thickened wall. The thickened wall was investigated further by endoscopic ultrasonography (EUS) , using perfluorobutane as a contrast agent. EUS clearly demonstrated cystic lesions, suggesting Rokitansky-Aschoff sinuses in the thickened wall, consistent with the pearl necklace sign. The thickened wall was homogenously enhanced. These observations confirmed adenomyomatosis of the gallbladder, and suggested a low possibility of associated cancer. The patient was followed up with abdominal ultrasonography to confirm the diagnosis.
