Natural history of polypoid lesions in the gall bladder.

Abstract

Background-Although polypoid lesions ofthe gall bladder are frequently observed in asymptomatic subjects, the natural history of these lesions has never been studied using ultrasonography. Aim-The natural history of polypoid lesions ofthe gall bladder was investigated using ultrasonography. Subjects-Among 4343 patients who presented to the outpatient clinic of Tsuchiura Kyodo General Hospital in 1988, 111 subjects were diagnosed as having polypoid lesions of the gall bladder by ultrasonography. Among these patients, two had gall bladder carcinoma. The remaining 109 subjects (58 female; age: median 54, range 25-89) were enrolled in this study. Methods-The subjects were followed up by ultrasonography once or twice a year until 1994. Results-Four patients received cholecystectomy and two patients died of other causes during the observation period. In one patient, gall bladder carcinoma was found, but its location was different from that of the pre-existing polyp. The size of the lesions did not change in 88.3% of the other 130 patients during this period, even among those in whom the initial size ofthe lesion exceeded 10 mm. There was no apparent correlation between the change in the diameter ofthe polypoid lesions and patients' sex or age. Conclusion-Most polypoid lesions of the gall bladder detected by ultrasonography are benign. (Gut 1996; 39: 860-862) Keywords: gall bladder carcinoma, gall bladder polyp, prognosis, ultrasonography.Ultrasonography has been widely used in clinical medicine, and its usefulness has been reported in the diagnosis of calculous gall bladder disease.' Mass surveys for abdominal disease have recently been performed using ultrasonography, and polypoid lesions of the gall bladder have been one of the most common findings.There are several studies that describe the prevalence of gall bladder polyps.2A6 One epidemiological study in Japan shows that the prevalence of gall bladder polyps was 6.28% in men and 3.5% in women,2 and another showed 5.3%/o in men.3 In Denmark, the prevalence was 4.6% and 4.3% in men and women, respectively,4 and 5.9% and 5.8% in men and women, respectively, in a 70 year old population.5 The prevalence was as low as 1.3% in the United Kingdom.6 However, the only report on the prognosis ofpolypoid lesions of the gall bladder is an old study using cholecystography. Therefore, the natural history of patients with polypoid lesions of the gall bladder was studied in this study. MethodsUltrasonographic examinations were carried out on 4343 patients in the outpatient clinic of the Department of Internal Medicine, Tsuchiura Kyodo Hospital from 1 January to 31 December 1988. Among these patients, 1 1 1 were diagnosed as having polypoid lesions of the gall bladder. Two of them had gall bladder carcinoma. The remaining 109 subjects (58 females; age: median 54, range 25-89) were enrolled in this study. After an overnight fast, ultrasonographic examination was performed by a radiology licensed :echnician using an Aloka Echo Camera SSD-650CL equipped with a 3.5 MHz tran...

Differential diagnosis of large-sized pedunculated polypoid lesions of the gallbladder by endoscopic ultrasonography: a prospective study

“…Although the natural history of pedunculated polypoid lesions of the gallbladder has not yet been completely elucidated, 19 the results of this study support the validity of our EUS diagnostic criteria for these types of lesions, and indicate that EUS is useful for making decisions on their treatment.…”

Late Follow-Up of Polypoid Lesions of the Gallbladder Smaller Than 10 mm

“…2,5,6 Although there are several studies describing the prevalence of these PLGs, [7][8][9][10][11][12] their eventual malignant potential, 10,13 and their relationship with gallstones, 3 based on resected gallbladders, there has been only one previous report concerning the natural history and behavior of nonoperated PLGs smaller than 10 mm. 14 The purpose of the present prospective study was to perform a late follow-up of patients with PLG by clinical and ultrasonographic evaluation to determine the appearance of biliary symptoms, the eventual modifications in number or size of the lesions, and the relationship with the appearance of stones or adenocarcinoma of the gallbladder.…”

Can Endoscopic Ultrasonography Differentiate Nonneoplastic from Neoplastic Gallbladder Polyps?

“…tomatic patients with nonneoplastic lesions do not require surgery (11,12). Endoscopic ultrasonography (EUS) is considered to be superior to US for imaging the gallbladder (13)(14)(15).…”