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

Kimura, Kazuhiro; Fujita, Naotaka; Noda, Yutaka; Kobayashi, Go; Ito, Kei

doi:10.1007/s005350170046

Cited by 38 publications

(39 citation statements)

References 10 publications

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“…It is not displaced by movements of the patient, has a nodular or smooth shape, and casts no posterior acoustic shadow [28]. It also shows a rapid growth [29]. However, these US findings do not provide reliable differentiation between a carcinoma and other non-neoplastic lesions such as cholesterol polyps or adenomyomatosis [28,29].…”

Section: Ultrasound In Gbcmentioning

confidence: 96%

Application of modern imaging methods in diagnosis of gallbladder cancer

Rodrı́guez-Fernández

Gómez-Río

Medina-Benítez

et al. 2006

Journal of Surgical Oncology

104

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The poor prognosis of gallbladder cancer (GBC) is related to its dissemination capacity and usually late diagnosis due to its non-specific clinical appearance. Recent improvements in hepatobiliary surgery have underlined the importance of an early specific diagnosis, which requires a multidisciplinary approach and, when possible, specialized equipment. The first step in an early diagnosis is to identify patients in the appropriate epidemiological setting (e.g., incidental finding, chronic cholecystitis) for the correct interpretation of test results. It is desirable to enhance the sensitivity of the initial ultrasound (US) examination by use of the appropriate technology in skilled specialist hands. When GBC is suggested by US findings, FDG-PET can be considered complementary to establish the benign/malignant nature of the lesion and to obtain a primary staging study. If GBC is confirmed, thin slice spiral CT can contribute valuable information on local spread. In this regard, recent hybrid PET-CT systems provide structural and functional information simultaneously and may offer early and accurate T, N, and M staging with an improved specificity.

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Section: Ultrasound In Gbcmentioning

confidence: 96%

Application of modern imaging methods in diagnosis of gallbladder cancer

Rodrı́guez-Fernández

Gómez-Río

Medina-Benítez

et al. 2006

Journal of Surgical Oncology

104

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“…Several studies have evaluated endoscopic ultrasonography for polypoid gallbladder lesions (22)(23)(24). Such images appear promising for distinguishing cholesterol polyps from other polyps, and the overall accuracy for differentiating neoplastic from non-neoplastic masses was reported as 91.1% (22). Endoscopic ultrasonography is highly accurate in the diagnosis of cholesterol polyp and adenomyomatosis, which represent the most common types of gallbladder polyps.…”

Section: Endoscopic Ultrasonographymentioning

confidence: 99%

Diagnosis of Gallbladder Tumors

2011

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Gallbladder cancer is among the organs examined in mass screening for cancer using ultrasonography; the reported prevalence of gallbladder cancer in such screening of a general population was 0.011%, while the prevalence of gallbladder polyps was reported as 4.3 to 6.9%. Endoscopic ultrasonography is useful for the differential diagnosis of gallbladder tumors detected by mass screening, as well as for estimating the depth of tumor invasion and detecting abnormal connections between pancreatobiliary ducts. While a systematic approach leading to diagnosis by endoscopic ultrasonography is useful, recent advances of contrast-enhanced ultrasonography are expected to establish it as a new modality for early detection. At our hospital, 7 of 26 patients with abnormal connections between pancreatobiliary ducts developed gallbladder carcinoma (23.1%), and 7 of 48 patients with gallbladder carcinoma had abnormal connections between pancreatobiliary ducts (12.5%). Serial observation in patients with gallstones and prophylactic surgery in patients with abnormal connections between pancreatobiliary ducts are necessary.

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“…[1][2][3][4][5] Longitudinal follow-up studies show that small lesions (<10 mm) that are monitored with imaging technology have a low incidence of carcinoma 3 and over a 5-year follow-up period no morphological abnormalities, in terms of the size of polyps, were observed in around 88% of patients. 5,8,10,11 Malignant GPs are significantly more common in patients aged over 50 and are single lesions of a sessile nature with a diameter of more than 10 mm. 1,2,3,6 This is borne-out by the results from our patient series, where the odds ratio was 3.6.…”

Section: Discussionmentioning

confidence: 99%

“…A cholesterol polyp shows as a mass with similar echogenicity to the gallbladder wall and with no shadow cone. 4,5,7,8,9 However, the distinction is difficult to make, and the status of polyps as benign or malignant cannot be determined with abdominal ultrasound alone. Intravenous cholecystography is a safe technique, but gallbladder polyps do not become sufficiently opaque.…”

Section: Discussionmentioning

confidence: 99%

Pólipos da vesícula biliar. Como e quando tratar?

Matos¹,

Baptista²,

Pinheiro³

et al. 2010

Rev. Assoc. Med. Bras.

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objectIve. The objective of this study was to determine the correct therapeutic management for patients with gallbladder polyps (GPs), what type of surveillance should be employed and how to differentiate between benign and malignant polyps in addition to also to providing reassurance in cases of "cancerophobia". Study design: This was a 5-years retrospective study. Location: The study was conducted at a Surgery Department at the Hospitais da Universidade de Coimbra. Population: We analyzed all patients operated on at the Surgery Service II from January 2003 to December 2007 who had had a preoperative diagnosis of GP. Methods. Clinicopathological correlations were traced for all patients. The following were analyzed: demographic data, clinical presentation, principal symptoms, associated pathologies, supplementary tests and diagnoses. results. We studied 93 patients, 91 of whom had benign polyps and two of whom had malignant polyps. Of the 91 benign polyps, 73 (78.5%) were cholesterol polyps, 14 (15%) were hyperplastic and two (2.2%) were adenomas. Two (2.2%) patients had malignant polyps, both adenogallbladder carcinomas. The mean diameter of benign polyps was 6 mm and 40 (43%) patients had multiple lesions. The mean diameter of malignant and premalignant polyps taken together was 18.8 mm, all were single polyps and the mean age of this patient subset was 57.7 years. conclusIon. It was concluded that the surgical option for GPs is cholecystectomy and that this should only be undertaken in cases where there are clinical signs of GP; polyps with diameters greater than 10 mm; fast-growing polyps; sessile polyps or wide-based polyps; polyps with long pedicles; patient aged over 50; concurrent gallstones; polyps of the gallbladder infundibulum or abnormal gallbladder wall ultrasound.

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

Abstract: EUS is useful for determining treatment indications for pedunculated polypoid lesions of the gallbladder, even when the lesions are large, and contributes to avoiding unnecessary surgery.

Cited by 38 publications

References 10 publications

Application of modern imaging methods in diagnosis of gallbladder cancer

Application of modern imaging methods in diagnosis of gallbladder cancer

Diagnosis of Gallbladder Tumors

Pólipos da vesícula biliar. Como e quando tratar?

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