Benign vs 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

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.

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rID: 9716
Synonyms or Alternate Spellings:
  • Benign versus malignant features of gallbladder polyps

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