This case shows enlarged obstructed gallbladder with features of acute calculous cholecystitis with intramural abscesses, suggested by the presence of marked diffusion restriction. Features raise the possibility of xanthogranulomatous cholecystitis secondary to chronic obstruction.  

The case also shows choledocholithiasis and marked upstream biliary dilatation by multiple intraluminal CBD stones, which is the cause of the patient's presentation with obstructive jaundice.​

The differentiation between malignant versus benign mural thickening based on DWI imaging is difficult and DWI findings should be interpreted in conjunction with standard MRI sequences. Benign mural thickening is usually smooth and diffuse with preserved mucosal contour, unlike the solid and asymmetric thickening of tumors.