Benign vs. malignant features of gallbladder polyps

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

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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rID: 9716
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