Giant fibrous polyp of the gallbladder: How to differentiate it from early carcinoma

What is it about?

Although polyp size and stalk diameter are significant for the differential diagnosis of the gallbladder polyp, it is necessary to catch genuine polyp characteristics to differentiate a giant fibrous polyp from gallbladder carcinoma (GBC). This case reviews and analyses the images and their correlation with the pathology.

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Photo by Boris Smokrovic on Unsplash

Photo by Boris Smokrovic on Unsplash

Why is it important?

An ultrasound depicted a giant pedunculated gallbladder polyp with a thick stalk. A contrast-enhanced ultrasound (CEUS) revealed a dendritic enhancement during the early vascular phase and a periphery-dominant enhancement during the post vascular phase. Although a pre-contrast CT did not demonstrate a gallbladder mass, a dynamic study revealed a gallbladder mass with a periphery-dominant enhancement, which was unique and noticeable. Without findings suggesting a GBC, a full-thickness laparoscopic cholecystectomy was performed. The histopathology demonstrated a fibrous polyp with a thick stalk. The polyp stroma consisted of edematous connective tissue containing gland- or duct-like elements and scattered inflammatory cell infiltrates. Capillaries were relatively evident in the periphery, and larger blood vessels were in the center. These findings coincide with a periphery-dominant contrast enhancement.

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