Benign vs malignant features of gallbladder polyps
Dr Frank Gaillard et al.
In most instances predicting histology of a gallbladder polyp based purely on imaging is not possible. A number of features are however helpful in helping to decide management of a polypoid lesion of the gallbladder.
Benign features
- size
- polyps that are less than 5 mm in size are almost always cholesterol polyps 1
- 5 - 10 mm polyps may warrant follow-up to ensure no interval growth 1
- morphology
- pedunculated
- number
- >50% of cholesterol polyps are multiple 3
- growth
- stable size
- CT / MRI enhancement
- similar to the rest of the gallbladder wall
- US features
- small echogenic focus / cluster of foci
- comet tail artefact (cholesterol polyp)
Malignant features
- size
- greater than 10 mm : 37-88% are malignant 4
- morphology
- sessile 1-2
- number
- solitary lesion 2
- growth
- interval increase in size 1-2
- CT / MRI enhancement
- greater than the normal gallbladder wall 1-2
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