Update: We are now collecting Disclosures from all users who edit content. You will be prompted to update these when you next edit content or you can complete your disclosures at any time in your user profile. This has been reflected in an updated terms-of-use.

Benign vs malignant features of gallbladder polyps

Last revised by Dr Jeremy Jones on 19 Sep 2021

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

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.

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.