Gall Bladder Wall Cyst [ Possibly Submucous Cyst ]: An Ultrasound Diagnosis

A 22yrs old female presented with h/o vague upper abdominal pain , was examined with ultrasound  showed -  a well defined smooth & regular walled  oval shaped cystic lesion bulging within gall bladder lumen  near neck as hypoechoic  filling defect . The lesion appears to be involving anterior wall of gall bladder near neck with bulging mucosa within lumen & showed low level homogeneous internal echos[may be altered mucoid fluid ] , & did not reveal internal vascularity on Doppler  [ fig 1 & 2].   The 3-D reconstruction image further confirmed the  lesion  to be mural & cystic lodged near gb neck [fig 3 & 4]. No any other evidence of cholecystitis or wall abnormality or  calculi was seen. No pericholecystic fluid or  biliary tree dilatation  was present. Case by: Subhash Tailor, MD, Bhilwara [ Rajasthan]

On the basis of classical US findings  a diagnosis of ‘ gall bladder wall cyst’  was made , possibly containing altered fluid [may be mucoid or hemorrhagic or infected ].   This appears to be a very uncommon &rare ultrasound finding, related to gall bladder pathologies, observed during routine scan  , &  may be an  incidentally detected  clinically insignificant  lesion , yet  important  to depict , & put up in gall bladder image gallery.    Opinion & comments are  welcome.