Gallbladder cholesterol polyps

Gallbladder cholesterol polyps are the most common subtype of gallbladder polyps, representing more than 50% of all polyps. They are frequently seen in middle-aged women and are benign lesions, with no malignant potential. 

For further details, please refer to the parental article on gallbladder polyps. 

Pathology

Macroscopic appearance

Cholesterol polyps appear as yellow, lobulated, and often pedunculated small lesions. They are usually multiple and, when diffuse, can lead to a strawberry gallbladder appearance. 

Microscopic appearance

Cholesterol polyps result from the deposition of cholesterol esters within the gallbladder wall lamina propria. This deposition results in polypoid lesions that are covered by a normal epithelium ^1,2. 

Radiographic features

Ultrasound

They present usually as multiple intraluminal gallbladder polypoid lesions ^2,3: 

• small: usually 1 to 2 mm, but always <10 mm
• round or slightly lobulated
• adherent to the wall, non-mobile with changes in the decubitus 
• hyperechoic
• no posterior shadow
• comet tail artifact ⁴