Gallbladder polyps ultrasound: what the sonographer needs to know

Cocco, Giulio; Basilico, Raffaella; Pizzi, Andrea Delli; Cocco, Nino; Boccatonda, Andrea; D’Ardes, Damiano; Fabiani, S.; Anzoletti, Nelson; D’Alessandro, P.; Vallone, Gianfranco; Cipollone, F.; Schiavone, Cosima

doi:10.1007/s40477-021-00563-1

Cited by 30 publications

(38 citation statements)

References 37 publications

(98 reference statements)

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“…Adenomyomatosis may involve the gallbladder according to four main patterns: localized, annular, segmental, and diffuse [ 8 ]. The segmental is fundus but the annular is in the middle, which is like an hourglass, dividing the lumen gallbladder into the fundal and neck compartment.…”

Section: Discussionmentioning

confidence: 99%

Diffuse Gallbladder Adenomyomatosis in a Child

Pham¹,

Xuan²,

Dang³

2021

Cureus

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Adenomyomatosis of the gallbladder is a benign condition, usually occurring in middle age, in which the epithelium of the gallbladder proliferates and the gallbladder wall thickens with the presence of Rokitansky-Aschoff sinuses (RAS). The diffuse form is an unusual subtype of adenomyomatosis. Herein, we describe a 17-year-old female who presented with dull and intermittent pain in the right hypochondriac region for more than a month. Ultrasound followed by magnetic resonance imaging showed marked diffuse gallbladder wall thickening. A gross cholecystectomy specimen showed a diffusely enlarged gallbladder. The final diagnosis of gallbladder adenomyomatosis (GA) was confirmed by the histopathologic appearance of muscular and epithelial hyperplasia, contributing to mural thickening with epithelial invaginations forming the pathognomonic intramural diverticula known as the RAS. This case highlights that the diffuse form of GA is uncommon and is often accompanied by chronic inflammation, sometimes requiring differential diagnosis from gallbladder malignancies, especially when there is no image showing a “comet tail” of cholesterol crystals in the wall.

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Section: Discussionmentioning

confidence: 99%

Diffuse Gallbladder Adenomyomatosis in a Child

Pham¹,

Xuan²,

Dang³

2021

Cureus

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“…Spectral analysis can reveal an arterial, relatively low-resistance flow, which is a non-specific finding. Differential diagnosis with B-mode and color-flow Doppler analysis between polypoid lesions and biliary sludge is not easy due to these non-specific signs found in the detection of GM [85,88]. CEUS is able to differentiate between a perfused gallbladder lesion and motionless biliary sludge [85].…”

Section: Ultrasound and Contrast-enhanced Ultrasoundmentioning

confidence: 99%

“…Although CEUS is nonspecific for the diagnosis of GM, it is useful in distinguishing between solid wall lesions and tumefactive biliary sludge. In these cases, CEUS shows the enhancement absence of the tumefactive biliary sludge in all phases, with a sensitivity and specificity of 100% [85,88]. CEUS may show hyper-enhanced mural tumor nodules and often the loss of gallbladder wall integrity with infiltration of surrounding liver tissue (Fig.…”

Section: Ultrasound and Contrast-enhanced Ultrasoundmentioning

confidence: 99%

“…On US, GM appears as a single or multiple mural nodules protruding into the lumen. The nodules usually have a large base, and their echogenicity is generally lower than usually seen in cholesterol and hyperplastic polyps [ 85 ]. Usually, a combined finding of biliary sludge and stones can be seen, and B-mode imaging can show the characteristic images of cholecystitis, sometimes due to obstruction of the cystic duct by the tumor mass [ 85 , 86 ].…”

Section: Ultrasound and Contrast-enhanced Ultrasoundmentioning

confidence: 99%

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Imaging of gallbladder metastasis

et al. 2021

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Gallbladder metastasis (GM) is a rare condition, often with a late diagnosis or detected upon autopsy. There is no extensive literature on the imaging diagnosis of GM. Here we present a comprehensive review of the literature with the aim of helping to interpret the clinical findings and imaging features of such patients. Few studies on GM are reported in literature. GM by melanoma accounts for about 55.6% of cases. The remaining cases origin from breast cancer (13.6%), hepatocellular carcinoma (13.6%), renal cell carcinoma (6.8%), lung cancer (4.5%), lymphoma (3.5%) and gastric cancer (2.4%). The most common clinical presentation of GM is abdominal pain from cholecystitis due to obstruction of the cystic duct. The main ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) findings that clinicians and radiologists should consider in their everyday medical activity were discussed. The diagnosis of GM was often achieved through a combination of more than one imaging modality. In more than 90% of cases, the diagnosis of GM is often late and combined with other organs involvement in the terminal stage of the malignancy. The knowledge of the clinical features and different imaging techniques through careful evaluation of the gallbladder can help to achieve early diagnosis and avoid misdiagnosis or false negative results.

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“…Pyloric gland tubular adenoma of the gallbladder is characterized by multiple microcysts inside a polyp; however, it is difficult to distinguish between cancer and this type of adenoma. Gallbladder adenoma, which can exhibit premalignant behavior (Figure 2), is a rare condition that accounts for 10% of ultrasonographically diagnosed gallbladder polyps [14]. It is usually solitary, 5-20 mm in size, and can be sessile or pedunculated [14,17,18].…”

Section: Diseases That Require Differentiation From Early Gallbladder Cancermentioning

confidence: 99%

The Role of EUS and EUS-FNA in Differentiating Benign and Malignant Gallbladder Lesions

Hijioka¹,

Nagashio²,

Ohba³

et al. 2021

Diagnostics

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Endoscopic ultrasonography (EUS) has greater spatial resolution than other diagnostic imaging modalities. In addition, if gallbladder lesions are found and gallbladder cancer is suspected, EUS is an indispensable modality, enabling detailed tests for invasion depth evaluation using the Doppler mode and ultrasound agents. Furthermore, for gallbladder lesions, EUS fine-needle aspiration (EUS-FNA) can be used to differentiate benign and malignant forms of conditions, such as xanthogranulomatous cholecystitis, and collect evidence before chemotherapy. EUS-FNA is also useful for highly precise and specific diagnoses. However, the prevention of bile leakage, an accidental symptom, is highly important. Advancements in next-generation sequencing (NGS) technologies facilitate the application of multiple parallel sequencing to EUS-FNA samples. Several biomarkers are expected to stratify treatment for gallbladder cancer; however, NGS can unveil potential predictive genomic biomarkers for the treatment response. It is believed that NGS may be feasible with samples obtained using EUS-FNA, further increasing the demand for EUS-FNA.

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Gallbladder polyps ultrasound: what the sonographer needs to know

Cited by 30 publications

References 37 publications

Diffuse Gallbladder Adenomyomatosis in a Child

Diffuse Gallbladder Adenomyomatosis in a Child

Imaging of gallbladder metastasis

The Role of EUS and EUS-FNA in Differentiating Benign and Malignant Gallbladder Lesions

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