Gallbladder polyp overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Gallbladder polyps are a common clinical findings occurring in 5% of patients who often have cross-sectional imaging for non-specific abdominal symptoms.
Pathophysiology
In patients with gallbladder polyps, it is important to note what type of polyp is described. While true polyps are adenomatous, gallbladder polyps are often non-epithelial growths and, in fact, about 70% of polyps are cholesterol polyps that have no malignant potential. Adenomas are uncommon and constitute approximately 8% of all gallbladder polyps. Less common polypoid lesions include gallbladder adenocarcinomas, inflammatory polyps, gallstones masquerading as polyps and heterotopic tissue.
Epidemiology and Demographics
The incidence of gallbladder polyps is higher among men than women. The overall prevalence among men of Chinese ancestry is 9.5%, higher than other ethnic types. [1] Polypoid lesions of the gallbladder affect approximately 5% of the adult population.[2] The causes are uncertain, but there is a definite correlation with increasing age and the presence of gallstones (cholelithiasis). Most affected individuals do not have symptoms. The gallbladder polyps are detected during abdominal ultrasonography performed for other reasons.
Natural History, Complications and Prognosis
After considering the type of polyps, the risk of development of cancer should be determined. Most demographic data suggest that men and women have an equal propensity to develop adenomatous polyps, however, one study found that men had an increased risk of polyp development. In addition, several studies have noted that patients with primary sclerosing cholangitis (PSC) that have polyps are more likely to develop adenocarcinoma. Finally, patients with advancing age may be predisposed to have cancer because some data suggests that gallbladder polyps, like colonic polyps, have an adenoma-to-carcinoma sequence and, therefore, advancing age would permit malignant transformation.
References
- ↑ Lin WR, Lin DY, Tai DI, Hsieh SY, Lin CY, Sheen IS, Chiu CT (2008). "Prevalence of and risk factors for gallbladder polyps detected by ultrasonography among healthy Chinese: analysis of 34,669 cases". Journal of Gastroenterol Hepatology. 23 (6): 965–9. PMID 17725602.
- ↑ Myers RP, Shaffer EA, Beck PL (2002). "Gallbladder polyps: epidemiology, natural history and management". Can J Gastroenterol. 16 (3): 187–94. PMID 11930198.