Polypoid lesions of the gallbladder: Disease spectrum with pathologic correlation

Vincent M. Mellnick, Christine O. Menias, Kumar Sandrasegaran, Amy K. Hara, Ania Z. Kielar, Elizabeth M. Brunt, Maria B. Majella Doyle, Nirvikar Dahiya, Khaled M. Elsayes

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Gallbladder polyps are seen on as many as 7% of gallbladder ultrasonographic images. The differential diagnosis for a polypoid gallbladder mass is wide and includes pseudotumors, as well as benign and malignant tumors. Tumefactive sludge may be mistaken for a gallbladder polyp. Pseudotumors include cholesterol polyps, adenomyomatosis, and inflammatory polyps, and they occur in that order of frequency. The most common benign and malignant tumors are adenomas and primary adenocarcinoma, respectively. Polyp size, shape, and other ancillary imaging findings, such as a wide base, wall thickening, and coexistent gallstones, are pertinent items to report when gallbladder polyps are discovered. These findings, as well as patient age and risk factors for gallbladder cancer, guide clinical decision making. Symptomatic polyps without other cause for symptoms, an age over 50 years, and the presence of gallstones are generally considered indications for cholecystectomy. Incidentally noted pedunculated polyps smaller than 5 mm generally do not require follow-up. Polyps that are 6–10 mm require follow-up, although neither the frequency nor the length of follow-up has been established. Polyps that are larger than 10 mm are typically excised, although lower size thresholds for cholecystectomy may be considered for patients with increased risk for gallbladder carcinoma, such as patients with primary sclerosing cholangitis.

Original languageEnglish (US)
Pages (from-to)387-399
Number of pages13
JournalRadiographics
Volume35
Issue number2
DOIs
StatePublished - Jan 1 2015

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ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Mellnick, V. M., Menias, C. O., Sandrasegaran, K., Hara, A. K., Kielar, A. Z., Brunt, E. M., Majella Doyle, M. B., Dahiya, N., & Elsayes, K. M. (2015). Polypoid lesions of the gallbladder: Disease spectrum with pathologic correlation. Radiographics, 35(2), 387-399. https://doi.org/10.1148/rg.352140095