From Jan. 1983 to Dec. 1993, 39 cases of gallbladder polyps (33: benign polyps, 6: malignant polyps) were identified among 2890 patients who underwent cholecystectomy. The authors investigated the clinical characteristics of gallbladder polyps
and
malignant potential of benign polyps by histologic examination.
Abdominal sonograms were examined in all patients, but polypoid lesions were detected in only 29 patients (sensitivity: 74.4%, false negativity: 25.6%). There were no specific differences in only 29 patients (sensitivity: 74.4%, false negativity:
25.6%). There were no specific differences in diagnostic accuracy between abdominal sonograms and endoscopic retrograde cholangiopancreatography(ERCP).
Pathologic diagnosis of the 33 cases of penign polyps were cholesterol polyps 20 cases(51.3%), adenomyomatous hyperplasia 5 cases(12.7%), inflammatory polyps 4 cases(10.3%), and adenoma 4 cases(10.3%). Six cases of malignant polyps were composed
of
1
case of adenoma with partial malignant change, 3 cases adenoma with total malignant change and 2 cases of adenoma accompanying adenocarcinoma. The average age of the patients was 43.8±9.7 years for pseudopolyps, 42.5±13.1 years for benign
adenomas.
57.3±13.3 years for malignant polyps. Increase in the average age of the patients with benign adenoma to those with adenoma showing malignant change(p<0.05). The average diameter of pseudopolyps was less than 10mm while for adenomas it was
12.5±2.5mm
and 18.5±4.6mm(p>0.05) for malignant adenoma. Most of the cases invaded to the mucosal layer except one case which invaded to the muscle layer.
In summary, adenomas of the gallbladder that are truly benign can be diagnosed using abdominal sonogram which also can be useful for follow-up. Though the incidence of adenoma is rare, adenoma has more malignant potential age and size increases.
When a polyp is detected, we should follow up with an aggresive attempt at accurate diagnosis because of the possibility of it being gallbladder carcinoma.
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