R. Maeyama et al., A LARGE INFLAMMATORY POLYP OF THE GALLBLADDER MASQUERADING AS GALLBLADDER CARCINOMA, Journal of gastroenterology, 33(5), 1998, pp. 770-774
An inflammatory polyp of the gallbladder is a rare variant of benign g
allbladder polyp. Differentiation between an inflammatory polyp and po
lypoid gallbladder carcinoma is difficult when the polyp is more than
1 cm in diameter. We report a rare case of a large inflammatory polyp
of the gallbladder masquerading as gallbladder carcinoma in a 37-year-
old Japanese woman who was incidentally diagnosed with a large gallbla
dder polyp, measuring 1 cm in diameter, by ultrasonography. She was as
ymptomatic and physical examination was unremarkable. Abdominal ultras
onography and endoscopic ultrasonography revealed three polypoid lesio
ns in the gallbladder. One lesion was an isoechoic polyp, measuring 15
x 8 mm, showing a nodular surface and located in the fundus of the ga
llbladder. The other two lesions were hyperechoic polyps, measuring 5
x 5 mm, in the body of the gallbladder. Computed tomography and magnet
ic resonance imaging revealed marked enhancement of the largest polypo
id lesion by dynamic study, and no lymph node enlargement was noted. E
ndoscopic retrograde cholangiography revealed a 12 x 8 mm polyp with a
n irregular surface in the fundus of the gallbladder. Superselective a
ngiography of the cystic artery revealed neovascularity and a tumor st
ain in the fundus of the gallbladder. Cholecystectomy with lymph node
dissection was performed. Intraoperative frozen section diagnosis of t
he largest polyp was an inflammatory polyp of the gallbladder. The oth
er two polyps were cholesterol polyps. Inflammatory polyp should be co
nsidered as a differential diagnosis of hypervascular gallbladder poly
ps that measure more than 1 cm in diameter.