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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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.


A giant gallbladder polyp with a thick stalk showing a periphery-dominant contrast enhancement could suggest a fibrous polyp.

Ph.D., M.D. Taketoshi Fujimoto
Iida Hospital

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This page is a summary of: Giant Fibrous Polyp of the Gallbladder Showing a Periphery-Dominant Contrast Enhancement: How to Differentiate It From Early Carcinoma, Journal of Diagnostic Medical Sonography, May 2022, SAGE Publications, DOI: 10.1177/87564793221100273.
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