A 35-year-old woman presents with right upper quadrant pain radiating to the right shoulder, worse after fatty meals. Ultrasound shows gallstones and a thickened gallbladder wall. Cholecystectomy specimen shows mucosal inflammation with Rokitansky-Aschoff sinuses. These sinuses represent:
- A Invasion of gallbladder carcinoma into the muscular wall
- B Lymphatic channels distended with mucin
- C Herniation of mucosa into and through the muscularis propria ✓
- D Heterotopic gastric mucosa in the gallbladder wall
Correct answer: C. Herniation of mucosa into and through the muscularis propria
Explanation
Rokitansky-Aschoff sinuses are herniations of the gallbladder mucosa through the muscular wall into the subserosal layer, formed due to increased intraluminal pressure from obstruction or chronic inflammation. They are a feature of chronic cholecystitis and adenomyomatosis and should not be confused with malignant invasion. Their presence indicates chronic obstructive pathology and is a marker of longstanding gallbladder disease.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.