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Figure 25b.   Adenomyomatosis in a 48-year-old man with chronic right upper quadrant pain. (a) Longitudinal sonogram shows diffuse gallbladder wall thickening and hyperechoic foci within the gallbladder wall that produce ring-down artifact (arrow). (b) Photograph of the bisected specimen shows marked thickening of the gallbladder wall and Rokitansky-Aschoff sinuses (arrows).