<prompt> Focal and diffuse thickening of gall bladder wall with high amplitude reflections and comet tail aifacts on USG suggest the diagnosis of:Xanthogranulomatous cholecysitisCarcinoma of gall bladderAdenomyomatosisCholesterolosis  <response>: 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 diveiculacryptsor sinus tracts so called Rokitansky-Aschoff Sinuses. It characteristically pesents with comet tail aifactssign 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. 