Nonneoplastic Tumors in gallbladder

Cholesterol Polyp/Cholesterolosis
Cholesterol polyps, or cholesterolosis, are the most common gallbladder polyps. The surgical literature refers to cholesterolosis as a “strawberry gallbladder.” They range from solitary to multiple. Gallstones may or may not be present. Cholesterolosis is often an incidental diagnosis, usually made by a pathologist. These polyps are not considered premalignant, although an occasional carcinoma is surrounded by glandular dysplasia and cholesterolosis; the carcinoma probably originates first and tumor epithelium then absorbed cholesterol from bile. Cholesterolosis is not part of the spectrum of acute cholecystitis. No association exists with systemic disorders such as atherosclerosis or diabetes. Even if detected preoperatively, cholesterolosis and adenomyomatosis are not believed to be indications for cholecystectomy. Smaller cholesterol polyps are not detected with unenhanced CT but become evident postcontrast.
Conventional US shows most larger cholesterol polyps to be pedunculated, have a granular surface, and tend toward a hypoechoic appearance, but smaller ones are mostly hyperechoic. Smaller polyps are nonmobile and adhere to the gallbladder wall, and both large and small are without acoustic shadowing. The
smaller ones tend to have a smooth outline; they become irregular with growth. Endoscopic US with its higher resolution is preferred over conventional US when evaluating gallbladder polyps.
Some authors suggest that persistence of gallbladder contrast 24 hours after an oral cholecystogram is indirect evidence of cholesterolosis. No objective data support this statement, and one should not rely on this finding. Although generally not warranted, US-guided percutaneous transhepatic needle aspiration cytology can diagnose cholesterol polyps.
Adenomyoma/Adenomyomatosis Adenomyomatosis presents either as a focal gallbladder narrowing or as diverticular-like outpouchings, most often in the gallbladder fundus. These outpouchings, also called cholecystitis glandularis proliferans, are believed to represent both mucosal herniation into muscularis propria and prominent Rokitansky- Aschoff sinuses. A rare report describes a carcinoma associated with adenomyomatosis, probably being coincidental. Although somewhat controversial, in most patients adenomyomatosis is generally believed not to be associated with symptoms.
In general, an oral cholecystogram provides more information about adenomyomatosis and cholesterolosis than US but is a procedure seldom performed today. Adenomyomatosis tends to be more prominent after a fatty meal and is best seen on a post–fatty meal oral cholecystogram. A number of prior reports of gallbladder diverticula probably describe adenomyomatosis; their imaging differentiation is not clear, although some authors do attempt to differentiate between these two entities. A typical appearance in a contrast-filled gallbladder consists of irregular diverticular-like outpouchings. When subtle, the fine granular outpouchings are difficult to identify with most current imaging techniques. At times imaging reveals a circumferential gallbladder fold resulting in an hourglass appearance. Superficially the latter condition mimics a gallbladder septum. A rare adenomyoma appears polypoid.
Magnetic resonance RARE sequences and breath-hold are superior to other pre- and postcontrast techniques in detecting Rokitansky- Aschoff sinuses. Adenomyomatosis is identified as small intramural foci hypointense on T1- and hyperintense on T2-weighted images. These outpouchings should not enhance postcontrast, but adjacent gallbladder mucosa does enhance, especially if concurrent inflammation is present, and thus the occasional description of adenomyomatosis as hypointense spots in a more hyperintense gallbladder wall. Small outpouchings blend into the gallbladder wall and result in a not uncommon postcontrast appearance of homogeneous, continuous wall enhancement.
Radiology images of T2–weighted image of adenomyomatosis. The gallbladder contains a transverse fold (arrow) and several gallstones (arrowhead). The pancreatic and bile ducts are dilated secondary to a pancreatic cancer.
Hyperplastic/Inflammatory Polyp Macroscopic hyperplastic polyps are uncommon, although an occasional large one is detected. Larger ones tend to enhance with contrast and angiography may even reveal neovascularity and a tumor stain. Ectopic Tissue (Pancreatic or Gastric) Heterotopic gastric mucosa or pancreatic tissue is occasionally found in the gallbladder. Most e polypoid, often located in the fundus. Ultrasonography reveals an echogenic polyp in the gallbladder.

Artikel Terkait

Nonneoplastic Tumors in gallbladder
4/ 5


Suka dengan artikel di atas? Silakan berlangganan gratis via email

This below all content of radiology information

Neuroradiology Musculoskeletal radiology MRI Musculoskeletal MRI Abnormal Mri Brain X-RAY differential diagnosis Head Neck Anatomy mnemonic CT Teleradiology Radiology News chest Radiology musculoskeletal salary pediatrics ultrasound ultrasound images job Brain tumour abdomen interventional radiology Apk Android CT Abdomen with contrast DAMS Imaging radiology ramblings residency c nature pediatric radiology random ramblings xray C T Radiology Top basics body imaging guide procedure web 2.0 Chest X Ray Interpretation Teleradiology Providers head and neck radiology video Fun Ultrasound Hepatitis b cancer chest radiology salary 1 CXR GenitoUrinary ORTHOPEDICS Sonographic Measurements Stroke dams md/ms coaching mammography radiology business tuberculosis BRAIN Clinicoradiological series FETUS GI radiology Gastrointestinal x ray Radiology 4 Radiology Conferences Radiology Images Telemedicine UPPER LIMPS Ultrasound in Emergencies dynamic MRI lifestyle radiology links renal case spine 3 tesla MRI Dams clinicoradiological series Entrepreneur Gastrointestinal Tract Images Literature Liver abscess ultrasound MD/MS coaching Radiology 40 Radiology Imaging Radiology Journal Radiology PDF Radiology mcqs Ultrasound Technique blog bone tumour cardiac CT career cerebral venous thrombosis chest xray d fracture gadolinium gastrointestinal genitourinary radiology hepatobiliary imaging lipoma medical blogs mri lower abdomen pelvis psychiatry radiation concern social networking technology training urogenital imaging weblog 3D CT Arachnoid cyst CT Cardiac Chest X Ray Diploma Guid Equipment Cost FDA Fibrous dysplasia Interventional Ultrasound Guiding Biopsi MDCT MR Pancreas MRI Vertebrae MRI Vertebrae lumbal MRI contrast MRS RTA Radiology Teaching resource TB Hip TECHNIQUE Tech Thorax X Ray Upper Ext aiims ankle sprain bowel cancer brain abscess case study computers and radiology contrast ependymoma epidermoid facebook guest post internet journal of radiology iphone kienbock disease liver liver segments ct locum tenens mri abdomen multislice CT pericallosal lipoma plain film teaching files private practice radiology humour shoulder arthrogram shoulder dislocation small bowel social media trigeminal neuralgia tuberous sclerosis venous x ray Vertebrae 3d printing 7 tesla MRI ACL reconstruction ACL tear ACLS AIIMS nov 2008 ALPSA lesion ANGIOGRAPHY ATFL B12 deficiency BLS BOLD Breast imaging Breast imaging Mammography CHF CT Paranasal CT Scanner Price CT angiography CT coronary angiography CT technology CV junction CXR teaching files Carcinoid Contrast Agent Creutzfeldt-Jakob Disease Dams MD/ms Dams grand rounds Diffusion weighted imaging Dysmenorrhea E E World Award 2011 EYE Embolization Imaging Entrepreneurship FMG India FMGE FNH Focal liver lesions ultrasound Focal nodular hyperplasia GBM GI Gall bladder Glioblastoma multiforme Glomus jugulare HEAD HEART HRCT HSG Head injury ICA dissection IRIA 2011 IUGR IVC filter Iliotibial Band Friction Syndrome Job Info Kidney Cancer LV thrombus Leptomeningeal cyst MAMOGRAPHY MCI Screening MD MPPG MR mammography MR urography MRA MRCP MRI Cervical MRI update MRI/PET MRV Mesenteric ischemia Middle East respiratory syndrome coronavirus (MERS-CoV) Motor neuron disease NECK Normal Liver US Oncology trial PDF Radiology PM and R Physician PNS Partial anomalous pulmonary venous drainage Persistent trigeminal artery Pg entrance Physiatrist Physiatry Physician Assistant Plastic Surgery Price MRI Machines 2017 Pulmonology Pulvinar sign Radiology Price List Radiology Today Radiology Updates Radiology grandrounds Radiology images of GI Tract Renal Ultrasound Retinal Surgery Rheumatology Ryles tube SKULL Seizure Sellar Masses Sleep Medicine Sports Medicine Subdural hematoma Surgery TBM TRIANGULAR FIBROCARTILAGE COMPLEX Trauma Surgery URI Ultrasound HIV Umbilical vein Update Article Upper Extremity X Ray Urology Usmle VHL Vascular Surgery Veteran Affairs X Ray Head about accessory bone acute cerebillitis acute pancreatitis aiims may 2011 aipg ankle ankle fracture apple articular cartilage aspergilloma atherosclerosis avulsion injury awards bankart lesion basilar artery thrombosis bilateral phaeochromocytoma biopsy bipolar bohler's angle bone tumours brachial plexus brain tb brainstem stroke branchial cyst breast cancer screening buford complex business today calcaneal fracture calcium scoring canned reports carcinoma esophagus carcinoma stomach cardiac ct/pet cardiac pacemaker cardiogen 82 cardiothoracic imaging catrotid artery dissection cavernoma cervical lymphnode levels chest radiographic score chest radiographs choledocolithiasis classification cloud computing cochlear implant colloid cyst communication in radiology compare case concha bullosa congenital brain anomalies congenital heart disease coronary CT coronary artery disease corpus callosum agenesis craniopharyngioma cryptococcal meningitis ct abdomen and pelvis cystic renal disease dams usmle dams visual treat deep brain stimulator dengue dengue hemorrhagic fever developmental dysplasia devices diagnostic imaging dialysis diffusion MR imaging diffusion tensor imaging diffusion tractography digital radiography distal facial neuroma dsa duplication gall bladder echinococcus echocardiography ectopic kidney elearning elevated diaphragm epilepsy esop facial neuroma fibular osteosarcoma functional mri gastrointenstinal tuberculosis germinoma gifts glioma google google plus gun shot injury haemangioblastoma health 2.0 healthcare consultancy hemangiblastoma hemophilia hippocampus hirayama disease hydatid cyst hypercoagulable hypoxic ischemic encephalopathy indian conferences inferior rectus anomaly infrared interior tomography interstitial lung disease intramedullary metastates intramedullary tuberculomas ipad ipad 2 jacoud's arthropathy kernohan's notch knee kohler's disease krukenberg tumour laceration leber's optic atrophy liver transplant lung contusion lymphatics macros marchifava bingami disease mastoiditis maxillary sinus mucocele medial malleolus ossicle medial tibial stress syndrome medical writting medicare medicolegal aspects of teleradiology migraine mortality motor area mri knee mri lumbal msk penang course mucinous cystadenoma multicentric Glioblastoma multiforme mycotic pseudoaneurysm of superficial temporal artery nephrogenic systemic fibrosis nephrology neurosurgery meets nonradiologist oesophagus olecranon spur online medical games open access opercular syndrome opinion orbit os odontoideum os radiale externum osirix osteochondritis osteochondroma osteoid osteoma outsourcing radiology ovarian tumour parameniscal cyst paranasal sinuses parotid vascular mass patellar sleeve avulsion fracture patent ductus arteriosus patent foramen ovale patient information pelvic MRI pericardial fat phaeochromocytoma pharmaceutical writting pineal tumour placenta accreta placenta increta placental insufficiency pneumococcal pneumonia polycystic kidney disease portal Hypertension posterior circulation stroke power point presentation primary complex protected health information pseudobulbar palsy pseudomyxoma peritonei publications pulmonary edema pulmonary embolism pulmonary tuberculosis rabbit ear sign rad radiographic deterioration pattern radiography radiolo radiologist blogs radiology city radiology debate radiology images of spleen radiology intervensional radiology learning radiology search engine radiology spotter radiology spotters radiolopolis raditudes rathke cleft cyst renal imaging renal sinus tumour right sided aortic arch robot round cell tumour sacral agenesis scaphoid fracture schatzki ring scientific content screening search engine secondaries secondary ossification centres silicosis social radiology soft tissue chondroma solitary pulmonary nodule spectroscopy spinal arachnoid cyst spinal cord tumours spinal osteochondroma spine tumour spinoglenoid cyst sternal tuberculosis stress fracture sacrum stroke mri sub-acute combined degeneration subclavian pseudoaneurysm subependymal giant cell astrocytoma sumer sethi swyer-james syndrome syringomyelia tb teaching video teleradiolo teleradiology business models teleradproviders teleultrasound temporal bone fracture tendoachilles testicular tumour tethered cord. MRI tibial stress fracture total knee arthroplasty total shoulder replacment trachea. tracheal diverticulum tracheal stenosis tracheomalacia traumatic lung cyst triceps tear triquetral fracture tubercular abscess tuberculoma tuberculosis elbow ultrasound image of The segments of the liver umblical artery doppler uroradiology vascular malformation vasovist venous angioma ventriculitis video ct scan video mri viral encephalitis vitamin deficiency