Benign vs malignant features of gallbladder polyps
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Citation:
Gaillard F, Haouimi A, Morgan M, et al. Benign vs malignant features of gallbladder polyps. Reference article, Radiopaedia.org (Accessed on 27 Mar 2025) https://doi.org/10.53347/rID-9716
rID:
9716
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At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
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At the time the article was last revised Jeremy Jones had no recorded disclosures.
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- Benign versus malignant features of gallbladder polyps
In most instances predicting benign versus malignant histology of a gallbladder polyp based purely on imaging features is not possible. However, a number of features are helpful in helping to decide the management of a gallbladder polyp.
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 or cluster of foci
- comet tail artifact (cholesterol polyp)
Malignant features
- size
- >10 mm: ~62.5% (range 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
One should always take the pretest probability of disease into account as well. For instance, patients with a history of primary sclerosing cholangitis (PSC) have a higher likelihood of developing cholangiocarcinoma and a gallbladder polyp in these patients is a malignancy until proven otherwise.
References
- 1. Teaching Atlas of Abdominal Imaging. Mukesh Harisinghani, Peter Mueller. Thieme ISBN:1588906566 (find it at amazon.com)
- 2. Sugiyama M, Atomi Y, Kuroda A et-al. Large cholesterol polyps of the gallbladder: diagnosis by means of US and endoscopic US. Radiology. 1995;196 (2): 493-7. Radiology (abstract) [pubmed citation]
- 3. Surgical Ultrasound: An Interdisciplinary Approach for Surgeons, Internists, and Ultrasound Technicians, Rene Mantke (Editor), Ulrich Peitz (Editor), Thieme; 1 edition (January 8, 2007) (find it at amazon.com)
- 4. Levy AD, Murakata LA, Abbott RM et-al. From the archives of the AFIP. Benign tumors and tumorlike lesions of the gallbladder and extrahepatic bile ducts: radiologic-pathologic correlation. Armed Forces Institute of Pathology. Radiographics. 22 (2): 387-413. Radiographics (full text) [pubmed citation]
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