A CLINICAL STUDY OF POLYPOID LESIONS OF THE GALLBLADDER

Various clinical analysises were undertaken in 35 patients with polypoid lesions of the gallbladder who had recently been surgically treated in our department. The lesions consisted of carcinoma of the gallbladder in 10 patients, adenomyosis in 8, hyperplastic polyps in 5, inflammatory polyps in 2 and adenoma in one. Most of them manifested gallstone-like symptoms even if no complication of gallstones was present, and the hyperplastic polyps and cholesterol polyps were multiple. As a result of examination in terms of size and macroscopic morphology, most benign cases showed a lesion diameter of less than 10 mm, whereas the lesions of carcinoma of the gallbladder showed a diameter of more than 10 mm in all 10 cases, indicating that lesions with a diameter of more than 10 mm should be diagnostically suspected of being malignant. The pedunculated type was often observed in benign cases, while the sessile type with a wide base was seen in many lesions of carcinoma of the gallbladder. The rate of correct diagnosis by ultrasonography in cases without complication of gallstones was high, 88.9%, whereas the rate in those combined with gallstones was low, 28.8%. This result suggested the necessity of scrupulous examination for the presence of polypoid lesions and morphlogy by being constantly aware of the possibility of conditions other than gallstoens even if gallstones are detected by ultrasonography.