Although most gallbladder (GB) polyps are benign, some early carcinomas of the GB share the same appearance as benign polyps. Currently, GB polyps larger than 1 cm should be surgically removed because of the increased risk of malignancy. On the other hand, patients with smaller polyps usually require repeated US and follow-up. Distinguishing among non-neoplastic, neoplastic, and potentially malignant lesions is a major diagnostic dilemma, and the therapeutic options for these lesions remain controversial.
A research article to be published in May 21, 2009 in the World Journal of Gastroenterology addresses this question.
EUS is considered to be superior to conventional US for imaging GB lesions, because EUS can provide high-resolution images of small lesions at higher ultrasound frequencies (7.5-12 MHZ vs 3.5-5 MHz). Many studies have investigated the relationship between the neoplastic nature of GB polyps and their morphological characteristics such as the number of polyps, the polyp shape, the diameter of the largest polyp, the echo level and internal echo pattern, and the polyp margin. Among these variables, size is the most significant predictor of neoplastic polyps.
EUS could not differentiate malignant lesions from benign polyps less than 1.0 cm in size, because such small polyps do not often show findings typical of cholesterol polyps, localized types of adenomyomatosis, or neoplastic lesions. Thus, EUS alone is not sufficient for determining a treatment strategy for benign polypoid lesion of less than 1.0 cm.
Reference: Cheon YK, Cho WY, Lee TH, Cho YD, Moon JH, Lee JS, Shim CS. Endoscopic ultrasonography does not differentiate neoplastic from non-neoplastic small gallbladder polyps. World J Gastroenterol 2009; 15(19): 2361-2366 http://www.wjgnet.com/1007-9327/15/2361.asp
Correspondence to: Dr. Young Koog Cheon, Institute for Digestive Research and Digestive Disease Center, Soon Chun Hyang University College of Medicine, 657 Hannam-Dong, Yongsan-Ku, Seoul 140-743, South Korea. yksky001@hanmail.net
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology