To clarify the malignant potentiality and clinical significanty of gall bladder adenoma, 2,235 patients treated with cholecystectomy from 1979 to 1991 were reviewed. Histopathological examinations were retried to classify the gall bladder polyps
according to our criteria.
Among them, 21 cases involved adenomatous portions in their pathological lesion. Ten benign adenomas, 3 dysplastic adenomas, 3 adenocarcinoma with adenomatous portions, and 5 invasive adenocarcinomas were found, Benign adenomas were all tubular
types
and malignant polyps were almost papillary types. Gall stones association rate was 62% in benign and 5% in malignant varieties. Three metaplastic changes were seen in two benign polyps and one malignant plyp transition from benign adenoma to
malignant
was seen.
Average diameter of polyps was 6±3.2 mm in adenomas, 21.7±5.8 mm in dysplastic polyps, 25 m in adenocarcinoma with adenomatous portions, and 37.8±8.4 mm in invasive cancers. Benign adenomatous group had statistical singificance to other
varities(P
value<0.05).
So authors think polypoid lesion which is larger than 10 mm must be resected because of the possibility of malignancy.
|