ABSTRACT
Background : Gall Bladder Polyps are mucosal lesions that project from the Gall Bladder wall into the Gallbladder lumen. They form morphologically distinct lesion/s with internal characteristics different than that of neighboring structures as verified by microscopic examination. About 4-6% are picked up clinically, 2-12% in Cholecystectomy specimens and 4% on Ultrasound. Materias and Methods : A three calendar year retrospective single surgical unit study compromised of 1442 cholecystectomies performed for benign Gall Bladder Disease. The patient were subjected to Ultrasound of abdomen for diagnosis and routine clinic work up. The Gall Bladders Harboring Polyps were examined grossly for site ,number, and microscopy for histological details. Results : In a total number of 40 cases of Gall Bladder Polyp, females outnumbered males. This series spreads over age groups of 3rd decade - 9th decade, most of the patients were seen in 6th decade of life. Youngest patients were 27 years old and oldest one was 85 years old. Incidentally, none of the old patients had evidence of malignancy on histopathology in their Gall Badder Polyp, only 2% were necessitated for a pre-operative diagnosis of Gall Bladder Polyps alone. Rest required it for presence of Gallstones with or without Polyp. None of >10mm size showed any malignant change on histopathological examination. On the Contrary, among the polypoid lesions <10mm size, one polypid lesion (7mm) showed a malignant change (Carcinoma in situ) Conclusion : A predictive model for neoplastic potential of Gall Bladder Polyp may support clinical decision to achieve an ideal therapeutic outcome. Hence a need for reappraisal of management guidelines.
ABSTRACT
OBJECTIVE@#To explore the value of micro-flow imaging (MFI) in evaluating blood flow characteristics and differential diagnosis of gallbladder polypoid lesions.@*METHODS@#We retrospectively analyzed the clinical data and ultrasound images of 73 patients with gallbladder polypoid lesions, including 24 patients with pathologically confirmed neoplastic polyps (n=24) and 49 with non-neoplastic polyps (n=49). All the patients underwent conventional ultrasound, MFI and contrast enhanced ultrasound (CEUS) before cholecystectomy. The blood flow characteristics of the lesions in color Doppler flow imaging (CDFI) and MFI were compared, and the consistency of the findings by these two modalities with those of CEUS were evaluated by weighted Kappa consistency test. The diagnostic performance of MFI for gallbladder polypoid lesions was assessed.@*RESULTS@#There were significant differences between MFI and CDFI in the evaluation of blood flow characteristics of gallbladder polypoid lesions (χ2=37.684, P < 0.001). MFI showed better performance than CDFI in displaying the blood flow characteristics of the polyps. The consistency in the findings was 0.118 between CDFI and CEUS and 0.816 between MFI and CEUS. The sensitivity, specificity and accuracy of MFI in distinguishing neoplastic polyps from non-neoplastic polyps were 75.00%, 93.88% and 87.67%, respectively.@*CONCLUSION@#MFI has a good consistency with CEUS in displaying the blood flow characteristics of gallbladder polypoid lesions and can accurately distinguish neoplastic polyps from non-neoplastic polyps, thus providing new ultrasound diagnostic evidence to support clinical decisions on optimal treatments of gallbladder polypoid lesions.
Subject(s)
Humans , Contrast Media , Diagnosis, Differential , Gallbladder Diseases/diagnostic imaging , Polyps/pathology , Retrospective StudiesABSTRACT
Objective To explore the clinical effect of low frequency ultrasound combined with high frequency ultrasound in the diagnosis of polypoid lesions of gallbladder,and to provide reference for clinical diagnosis. Methods From January 2013 to January 2017,87 patients with gallbladder polypoid lesions in Hankou Hospital were selected as the subjects,all the patients were checked by low frequency ultrasound and high frequency ultrasound,the results were compared with postoperative pathological findings. The diagnostic effect were compared between the low frequency ultrasound and low frequency ultrasound combined with high frequency ultrasound,and the consistency between the two inspection methods and postoperative pathological results was analyzed. Results The postoperative pathological report showed that among the 87 patients,59 cases ( 67. 82%) had gallbladder polyp, 6 cases ( 6. 90%) had adenomyosis, 10 cases ( 11. 49%) had gallbladder adenoma, 12 ( 13. 79%) had small nodular gallbladder cancer, 65 ( 86. 67%) had benign polypoid lesions,73 (97. 33%) had low frequency ultrasound combined with high frequency ultrasound. The accuracy of combined high-frequency ultrasound in the diagnosis of benign gallbladder polypoid lesions was significantly higher than that of low frequency ultrasound (χ2＝5. 797,P＜0. 05); the specificity and positive predictive value of combined low frequency ultrasound and high frequency ultrasound in the diagnosis of benign gallbladder polypoid lesions were significantly higher than those of low frequency ultrasound(90. 00%and 41. 18%,97. 33% and 86. 67%) . The difference was statistically significant ( χ2 ＝6. 217, 5. 797, P＝0. 013,0. 016). Conclusion Compared with low frequency ultrasound,low frequency ultrasound combined with high frequency ultrasound improves the differential diagnosis effect of gallbladder polypoid lesions,which is worthy of clinical attention.
ABSTRACT
The diagnosis of polypoid lesions of the gallbladder plays a key role in the selection of treatment methods.However we still lack of effective means to exclude the malignant transformation currently.It is believed that lesions,whose diameter more than 10 mm,tend to be malignant.In addition,multiple imagings and related risk factors can also bring us some valuable tips.This article summarizes the current research progress related to the differential diagnosis of the disease,hoping to provide help for the clinicians in the timing of operation for such disease.
ABSTRACT
This article reviewed literatures on the treatment of polypoid lesions of gallbladder(PLG) with Traditional Chinese Medicine(TCM) in recent years. The research showed that TCM has satisfied therapeutic effects on PLG, which can avoid unnecessary operation. But the systemic theoretic and experimental studies have been insufficient, and further studies are needed.
ABSTRACT
Objective To investigate the operative indications for polypoid lesions of gallbladder(PLG) and avoid cholecystectomy for PLG without operation signs.Methods Retrospective analysis of 828 cases of PLG confirmed by pathologic examination was made.Results (1)Cancer should be suspected when a patient is older than 50 years or has a polypoid lesion larger than 1.0 cm.(2)The cholecystectomies for PLG accounted for 2.7%-7.1%of all cholecystectomies in the corresponding period,and cholesterol polyps accounted for 86.11%of all PLG,and carcinoma of gallbladder accounted for 1.92%of all PLG.Conclusion At present most of PLG accepting cholecystectomy are cholesterol polyps,so the high-risk factors of the neoplastic polyps and the operative indications for PLG should be considered deliberately.
ABSTRACT
PURPOSE: A laparoscopic cholecystectomy is now the gold standard for the treatment of gallstone disease. While the widespread use of ultrasonography has increased the frequency of the diagnosis of polypoid lesions of the gallbladder (PLG), no optimal strategies for evaluating and treating these lesions have been established. The aims of this study were to identify the risk factors for malignancy, and evaluate the usefulness of laparoscopic cholecystectomy for PLG. METHODS: The clinical and histopathological data from ninety PLG patients, who received a laparoscopic cholecystectomy, between January 1998 and December 2005, were retrospectively analyzed. Data were evaluated using a multiple logistical regression analysis. RESULTS: There were 82 benign PLG, including 38 cholesterol polyps, 22 adenomas, 18 hyperplastic polyps and 4 adenomyomas, and 8 malignant PLG. The average age of the patients with malignant PLG was significantly older than that of those with benign PLG (P=0.001). The average malignant PLG diameter was significantly larger than that of the benign PLG (P=0.000). The malignant PLG were mostly a single lesion; whereas, half of the benign PLG were multiple lesions. In the multiple logistical regression analysis, polyp sizes greater than 1.5 cm and an age over 50 years were the two most important factors for predicting malignancy of PLG. Seven of eight patients with malignant PLG are still alive at a mean of 43.8 months after surgery, and without any recurrence. CONCLUSION: The risk factors for malignancy were found to be the polyp size and patient age. A laparoscopic cholecystectomy can be considered an adequate treatment for patients with a stage I gallbladder carcinoma.
Subject(s)
Humans , Adenoma , Adenomyoma , Cholecystectomy, Laparoscopic , Cholesterol , Diagnosis , Gallbladder , Gallstones , Polyps , Recurrence , Retrospective Studies , Risk Factors , UltrasonographyABSTRACT
El diagnóstico de lesiones polipoideas de la cavidad uterina ha pasado por varias etapas. Con el advenimiento de métodos mas sensibles como la histeroscopía la histerosonografía se ha constatado que la presencia de los pólipos endometriales es mucho mayor. El tratamiento también ha pasado por varias etapas, desde la dilatación y legrado biopsia a "ciegas" hasta la resectoscopía quirúrgica bajo visión directa y la polipectomía "dirigida" por una histerosonografía previa. El objetivo de este trabajo fue evaluar el papel de la histerosonografía en el diagnóstico y tratamiento de lesiones polipoideas de la cavidad uterina. El estudio se realizó en el servicio de ginecología y obstetricia del hospital obrero No. 2 de la Caja Nacional de Seguro de Cochabamba. Se realizó histerosonografía en 15 pacientes, en ninguna se presentaron complicaciones, y de la totalidad de los pacientes con sospecha de pólipo endometrial, no se tenía referencias sobre su Iocalizacion ni la naturaleza de su base de implantación.
The diagnose of polypoid lesions of uterine cavity has passed by different steps: With the new more sensible methods like the hysteroscopy and hysterosonography. It has been shown that the presence of endometrial polypus is higher. The treatment also has passed several steps, since dilatation and blind legrade - biopsy until surgical resectoscopy under direct view and the "driven" polypectomy by a previous hysterosonnography The aim of this work was to evaluate the role of hysterosonnography on diagnose and treatment of polypoid uterine cavity lesions. The worgik was made at gynecology and obstetrics department of Hospital Obrero No. 2 of Caja Nacional de Seguro from Cochabamba. Hysterosonnography was carried out in 15 patients. None with complications, and from all patients sus-picious of endometriai polypus no one had references of its Iocation or nature of its implantation base.
Subject(s)
UterusABSTRACT
Objective To evaluate the difference between gallbladder polys,gallbladder adenomas and gallbladder cancer by sonography.Methods The imaging features were analysed including 571 patients with gallbladder polys,30 with gallbladder adenomas,109 with gallbladder cancer.Results The lesion diameter,echogram,color signals,maximum velocity(Vmax) and the resistive index(RI) were difference between Polys,Adenomas and cancers of gallbladder.When RI withinlesions lower than 0.65 was adopted as diagnostic criteria of gallbladder cancer,the specificity of the ultra-sound in diagnosis of gallbladder cancer were respectively.Conclusion Color Doppler flow imaging was useful in the differential diagnosis of gallbladder polypoid lesions in combination with gray-scale sonography.
ABSTRACT
Mucosa-associated lymphoid tissue (MALT) lymphoma of colon usually presents with a solitary lesion of polypoid appearance but may rarely present with multiple polypoid lesions. MALT lymphoma of colon presented as multiple polypoid lesions are not easy to differentiate from multiple lymphomatous polyposis. We experienced a case of MALT lymphoma of colon with a large mass in proximal ascending colon involving ileocecal valve and multiple polypoid lesions in entire colon.
Subject(s)
Colon , Colon, Ascending , Ileocecal Valve , Lymphoid Tissue , Lymphoma , Lymphoma, B-Cell, Marginal ZoneABSTRACT
10mm,solitary sessile,growth during follow-up,associated with gallstone,obvious symptomatic or novel imaging techniques indicating NPG occurs.