Abstract
An appropriate diagnosis is required to avoid unnecessary surgery for gallbladder cholesterol polyps (GChPs) and to appropriately treat pedunculated gallbladder carcinomas (GCs). Generally, polyps >10 mm are regarded as surgical candidates. We retrospectively evaluated plain and contrast-enhanced (CE) computed tomography (CT) findings and histopathological features of 11 early GCs and 10 GChPs sized 10–30 mm to differentiate between GC and GChP >10 mm and determine their histopathological background. Patient characteristics, including polyp size, did not significantly differ between groups. All GCs and GChPs were detected on CE-CT; GCs were detected more often than GChPs on plain CT (73% vs. 9%; p < 0.01). Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for GCs were 73%, 90%, 89%, 75%, and 81%, respectively. On multivariate analysis, lesion detectability on plain CT was independently associated with GCs (odds ratio, 27.1; p = 0.044). Histopathologically, GChPs consisted of adipose tissue. Although larger vessel areas in GCs than in GChPs was not significant (52,737 μm2 vs. 31,906 μm2; p = 0.51), cell densities were significantly greater in GCs (0.015/μm2 vs. 0.0080/μm2; p < 0.01). Among GPs larger than 10 mm, plain CT could contribute to differentiating GCs from GChPs.
Highlights
A gallbladder polyp (GP) is any type of elevated lesion of the gallbladder [1,2]
We retrospectively evaluated the findings on plain computed tomography (CT) and contrast-enhanced CT
All gallbladder carcinomas (GCs) and gallbladder cholesterol polyps (GChPs) could be detected on CE-CT, whereas GCs were detected significantly more often than GChPs on plain CT (73% vs. 10%; p < 0.01) (Table 2)
Summary
A gallbladder polyp (GP) is any type of elevated lesion of the gallbladder [1,2]. GPs are classified as benign or malignant according to the results of a histopathological evaluation.Benign GPs include non-tumorous polyps, such as gallbladder cholesterol polyps (GChP)or inflammatory polyps, whereas malignant GPs include gallbladder carcinoma (GC) [3,4].Among GPs, GChPs are common, while GCs are rare. A gallbladder polyp (GP) is any type of elevated lesion of the gallbladder [1,2]. GPs are classified as benign or malignant according to the results of a histopathological evaluation. Benign GPs include non-tumorous polyps, such as gallbladder cholesterol polyps (GChP). Inflammatory polyps, whereas malignant GPs include gallbladder carcinoma (GC) [3,4]. Among GPs, GChPs are common, while GCs are rare. An appropriate diagnosis is required to avoid unnecessary surgery of GChPs and to provide appropriate treatment for GCs. To differentiate between benign and malignant GPs, various methods have been reported, including high-resolution abdominal ultrasonography (AUS) [5], contrast-enhanced
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