Imaging based flowchart for gallbladder polyp evaluation

Wennmacker, Sarah Z.; Lohman, Elise A J de Savornin; Reuver, Philip R. de; Drenth, Joost P.H.; Post, Rachel S. van der; Nagtegaal, Irıs D.; Hermans, John J.; Laarhoven, Cornelis J. H. M. van; Schreinemakers, Jennifer M. J.; Heisterkamp, Joos; Hansson, B.; Buyne, Otmar R.; Nieuwenhuijs, Vincent B.; Bilgen, Ernst Jan Spillenaar; Bosscha, K.

doi:10.1016/j.jmir.2020.12.003

Cited by 11 publications

(10 citation statements)

References 42 publications

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“…We have to decide surgical indication for gallbladder polyps by not only the size but many other aspects such as singularity, wall thickening and presence of gallstones [ 6 ]. Recently, Wennmacker et al [ 7 ] suggested the new diagnostic flowchart for gallbladder polyps based on differences in signal intensity on diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) value of magnetic resonance imaging (MRI) in addition to the conventional ultrasonography.…”

Section: Discussionmentioning

confidence: 99%

Gallbladder Intramucosal Carcinoma Arising in a Cholesterol Polyp: A Case Report

Sasaki¹,

Kajiwara²,

Ishii³

et al. 2022

Cureus

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Cholesterol polyp is the most common benign disease of gallbladder polyps, and is considered not to be the origin of malignancy. Herein, we report a rare case of a well-differentiated adenocarcinoma arising in a gallbladder cholesterol polyp. A pedunculated mulberry-like gallbladder polyp diagnosed with a cholesterol polyp preoperatively consisted of two distinct components macroscopically: a yellow-whitish lobulated lesion and a brownish irregular lesion. Microscopically, the former revealed to be a cholesterol polyp, but the latter demonstrated a well-differentiated adenocarcinoma. Even if imaging findings suggest a gallbladder cholesterol polyp, it is important to keep in mind that carcinoma can coexist like our case.

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Section: Discussionmentioning

confidence: 99%

Gallbladder Intramucosal Carcinoma Arising in a Cholesterol Polyp: A Case Report

Sasaki¹,

Kajiwara²,

Ishii³

et al. 2022

Cureus

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“…A more feasible improvement in polyp determination, which the authors also touch on, will come from more dedicated ultrasounds and structured reporting of individual polyp characteristics. 11 Lobular surface, sessile polyp, focal wall thickening, vascular core and hypoechogenic internal pattern or foci have been mentioned to increase the chances of a polyp being neoplastic and would provide additional arguments for cholecystectomy. Hyperechoic internal pattern or foci are more common in cholesterol polyps and would prevent cholecystectomy and futile follow-up.…”

Section: European Societies Such As European Society Of Gastrointesti...mentioning

confidence: 99%

“…3,7 Further improvements in determining gallbladder polyps can come from technological advancements such as high-resolution, contrastenhanced ultrasound and microvascular imaging. [8][9][10][11][12] However, innovation, in this case, comes at the expense of generalisability, as not every centre has access to these advanced ultrasound systems. A more feasible improvement in polyp determination, which the authors also touch on, will come from more dedicated ultrasounds and structured reporting of individual polyp characteristics.…”

Section: European Societies Such As European Society Of Gastrointesti...mentioning

confidence: 99%

“…Further improvements in determining gallbladder polyps can come from technological advancements such as high‐resolution, contrast‐enhanced ultrasound and microvascular imaging 8–12 . However, innovation, in this case, comes at the expense of generalisability, as not every centre has access to these advanced ultrasound systems.…”

mentioning

confidence: 99%

“…However, innovation, in this case, comes at the expense of generalisability, as not every centre has access to these advanced ultrasound systems. A more feasible improvement in polyp determination, which the authors also touch on, will come from more dedicated ultrasounds and structured reporting of individual polyp characteristics 11 . Lobular surface, sessile polyp, focal wall thickening, vascular core and hypoechogenic internal pattern or foci have been mentioned to increase the chances of a polyp being neoplastic and would provide additional arguments for cholecystectomy.…”

mentioning

confidence: 99%

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Gallbladder polyps and the challenge of distinguishing benign lesions from cancer

Dooren

Reuver

2022

UEG Journal

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Gallbladder polyps and the challenge of distinguishing benign lesions from cancerThe challenge in the management of patients with gallbladder polyps is to prevent the development of gallbladder cancer and do no harm by unnecessary surgery or futile follow-up. But in daily practice, many lesions are inaccurately reported and overtreated. The prevalence of gallbladder polyps, depending on the population, ranges from 0.3%-9.5%. 1 These percentages accord with studies investigating the prevalence of gallbladder polyps on post-operative histopathological analysis after cholecystectomy (0.004%-13.8%). 2 Histopathologically, gallbladder polyps can be divided into two main categories: neoplastic and non-neoplastic. The great majority of lesions are non-neoplastic,

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AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma

et al. 2022

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Inclusion of guidance for the diagnosis and management of cholangiocarcinoma (CCA) in patients with and without primary sclerosing cholangitis (PSC) (Figures 5, 8, and 9). Introduction of the term relevant stricture, defined as any biliary stricture of the common hepatic duct or hepatic ducts associated with signs or symptoms of obstructive cholestasis and/or bacterial cholangitis (Table 1). In patients with equivocal MRI with cholangiopancreatography (MRI/MRCP) findings, a repeated high-quality MRI/ MRCP should be performed for diagnostic purposes. Endoscopic retrograde cholangiopancreatography (ERCP) should be avoided for the diagnosis of PSC (Figure 2).

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Imaging based flowchart for gallbladder polyp evaluation

Cited by 11 publications

References 42 publications

Gallbladder Intramucosal Carcinoma Arising in a Cholesterol Polyp: A Case Report

Gallbladder Intramucosal Carcinoma Arising in a Cholesterol Polyp: A Case Report

Gallbladder polyps and the challenge of distinguishing benign lesions from cancer

AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma

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