Evaluating Polypoid Lesions of the Gallbladder on Ultrasound

Description

Ultrasound can be used to characterize polypoid lesions of the gallbladder. It can help identify features that may indicate that the polyp may be malignant. Endoscopic ultrasonography may improve the resolution of the images.

Feature	Benign	Adenoma or Adenocarcinoma
diameter	<= 10 mm (1 cm)	> 10 mm
pattern	pedunculated	sessile or pedunculated
change in size over time	none	increase
overlying mucosa	intact	eroded
invasion into wall	none	may be present if malignant
number	multiple (3 or more)	few (1 or 2)
age	usually <= 60 years	> 60 years
cholelithiasis	may be present	may be present (arise in longstanding cholecystitis)

Features of cholesterolosis:

(1) multiple pedunculated polyps

(2) small in size (<= 10 mm)

(3) echogenic spot on ultrasound

Features of adenomyomatosis:

(1) multiple microcysts and/or "comet tail" (V-shaped reverberation) artifact on ultrasound

(2) sessile

(3) may be > 10 mm in diameter

Cholecystectomy is recommended if the patient is symptomatic and has one or more risk factors for malignancy.

Observation is acceptable for an asymptomatic patient with no risk factors for malignancy and no change in polyp size on serial ultrasound studies.

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Evaluating Polypoid Lesions of the Gallbladder on Ultrasound

Description

Specialty