Focal and diffuse thickening of gall bladder wall with high amplitude reflections and 'comet tail' aifacts on USG suggest the diagnosis of:

C i.e. Adenomyomatosis - Adenomyomatosis of gall bladder is chracterized by diffuse (generalized), segmental (annular) or localized hyperplastic muscular wall thickeningQ, mucosal overgrowth and intramural diveicula/crypts/or sinus tracts (so called Rokitansky-Aschoff Sinuses). It characteristically pesents with comet tail aifacts/sign (on USG), pearl necklace sign (on oral cholecystogram or MR cholangiogr, am) and string of beads sign (on MRCP T2WI). Most thyroid carcinomas are hypoechoicQ. Whereas most thyroid adenomas are hyperechoic or isoechoic at ultrasound. Adenomyomatosis of Gall bladder *Adenomyomatosis is a special case of Gall Bladder cholesteatosis and belongs to the group of Hyperplastic Cholecystoses. *It appears as a hyperechoic tumerous thickening of the gall bladder wall (generalized or focal) originating from hyperophied Rokitanski-Aschoff Sinuses (Intramural Diveiculae).