Large cholesterol polyps of the gallbladder: diagnosis by means of US and endoscopic US.
OBJECTIVE
To identify ultrasonographic (US) features of large cholesterol polyps (> 10 mm in diameter) of the gallbladder in the differential diagnosis of polypoid lesions.


METHODS
Sixty-seven patients underwent US (n = 67) and endoscopic US (n = 33). Fourteen patients had large cholesterol polyps. Findings in these patients were compared with those in patients with small cholesterol polyps (< or = 10 mm in diameter; n = 34) or other polypoid lesions (n = 19).


RESULTS
US demonstrated the large cholesterol polyps as pedunculated masses with granular surfaces. In 94% of patients, all small cholesterol polyps were echogenic whereas the large cholesterol polyps tended to have decreased echogenicity. Endoscopic US showed complete or partial aggregation of echogenic spots in all cholesterol polyps-but not in other polypoid lesions, which included carcinomas.


CONCLUSIONS
Aggregation of echogenic spots seems to be a US feature characteristic of both large and small cholesterol polyps. Routine use of endoscopic US is recommended for differential diagnosis of polypoid lesions because of its high resolution.
Sugiyama
M
M
First Department of Surgery, Tokyo University School of Medicine, Japan.
Atomi
Y
Y
Kuroda
A
A
Muto
T
T
Wada
N
N
D000230:Adenocarcinoma / Q000000981:diagnostic imaging; D018256:Adenomatous Polyps / Q000000981:diagnostic imaging; D018194:Adenomyoma / Q000000981:diagnostic imaging; D000328:Adult; D002784:Cholesterol / Q000378:metabolism*; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System; D005260:Female; D005706:Gallbladder Neoplasms / Q000737:chemistry / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000737:chemistry / Q000000981:diagnostic imaging*; D014463:Ultrasonography
D002784:Cholesterol