Endoscopic ultrasonography does not differentiate neoplastic from non-neoplastic small gallbladder polyps

Figure 1 Polypoid lesions of gallbladder. A: Cholesterol polyp of the gallbladder. EUS shows a 13-mm-diameter, granular-surfaced, pedunculated mass with an internal echo pattern characterized by an aggregation of echogenic spots. Histological examination of the surgical specimen showed a cholesterol polyp; B: Adenoma of the gallbladder. EUS shows a 10-mm-diameter, homogeneously isoechoic, pedunculated mass. The histological diagnosis was tubulovillous adenoma with focal high-grade dysplasia; C: Adenocarcinoma of the gallbladder. EUS shows a 19-mm-diameter, smooth-surfaced, heterogeneously echogenic, pedunculated mass. Histological examination of the surgical specimen showed adenocarcinoma.

Figure 2 Misjudged case diagnosed as adenoma or carcinoma before surgery. A: EUS shows a 17.5-mm-diameter, homogeneously isoechoic, pedunculated mass; B: Abdominal CT shows an enhanced polypoid mass of the gallbladder in arterial phase. Histological examination of the surgical specimen showed a cholesterol polyp.