Gallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions

dc.authorid0000-0001-6830-7701
dc.contributor.authorTaşkın, Orhun C.
dc.contributor.authorBaştürk, Olca
dc.contributor.authorReid, Michelle D.
dc.contributor.authorDursun, Nevra
dc.contributor.authorBağcı, Pelin
dc.contributor.authorSaka, Burcu
dc.contributor.authorBalcı, Serdar
dc.contributor.authorMemiş, Bahar
dc.contributor.authorBellolio, Enrique
dc.contributor.authorAraya, Juan Carlos
dc.contributor.authorRoa, Juan Carlos
dc.contributor.authorTapia, Oscar
dc.contributor.authorLosada, Hector
dc.contributor.authorSarmiento, Juan
dc.contributor.authorJang, Kee-Taek
dc.contributor.authorJang, Jin-Young
dc.contributor.authorPehlivanoğlu, Burçin
dc.contributor.authorErkan, Mert
dc.contributor.authorAdsay, Volkan
dc.date.accessioned2020-10-12T12:38:33Z
dc.date.available2020-10-12T12:38:33Z
dc.date.issued2020
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Tıbbi Patoloji Ana Bilim Dalı
dc.description.abstractBackground Different perspectives exist regarding the clinicopathologic characteristics, biology and management of gallbladder polyps. Size is often used as the surrogate evidence of polyp behavior and size of >= 1cm is widely used as cholecystectomy indication. Most studies on this issue are based on the pathologic correlation of polyps clinically selected for resection, whereas, the data regarding the nature of polypoid lesions from pathology perspective -regardless of the cholecystectomy indication- is highly limited. Methods In this study, 4231 gallbladders -606 of which had gallbladder carcinoma- were reviewed carefully pathologically by the authors for polyps (defined as >= 2 mm). Separately, the cases that were diagnosed as "gallbladder polyps" in the surgical pathology databases were retrieved. Results 643 polyps identified accordingly were re-evaluated histopathologically. Mean age of all patients was 55 years (range: 20-94); mean polyp size was 9 mm. Among these 643 polyps, 223 (34.6%) were neoplastic: I. Non-neoplastic polyps (n = 420; 65.4%) were smaller (mean: 4.1 mm), occurred in younger patients (mean: 52 years). This group consisted of fibromyoglandular polyps (n = 196) per the updated classification, cholesterol polyps (n = 166), polypoid pyloric gland metaplasia (n = 41) and inflammatory polyps (n = 17). II. Neoplastic polyps were larger (mean: 21 mm), detected in older patients (mean: 61 years) and consisted of intra-cholecystic neoplasms (WHO's "adenomas" and "intracholecystic papillary neoplasms", >= 1 cm; n = 120), their "incipient" version (<1 cm) (n = 44), polypoid invasive carcinomas (n = 26) and non-neoplastic polyps with incidental dysplastic changes (n = 33). In terms of size cut-off correlations, overall, only 27% of polyps were >= 1 cm, 90% of which were neoplastic. All (except for one) >= 2 cm were neoplastic. However, 14% of polyps <1 cm were also neoplastic. Positive predictive value of >= 1 cm cut-off -which is widely used for cholecystectomy indication-, was 94.3% and negative predictive value was 85%. Conclusions Approximately a third of polypoid lesions in the cholecystectomies (regardless of the indication) prove to be neoplastic. The vast majority of (90%) of polyps >= 1 cm and virtually all of those >= 2 cm are neoplastic confirming the current impression that polyps >= 1 cm ought to be removed. However, this study also illustrates that 30% of the neoplastic polyps are <1 cm and therefore small polyps should also be closely watched, especially in older patients.
dc.identifier.citationTaşkın, O. C., Baştürk, O., Reid, M. D., Dursun, N., Bağcı, P., Saka, B. ... Adsay, V. (2020). Gallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions. PLOS One, 15(9). https://dx.doi.org/10.1371/journal.pone.0237979
dc.identifier.doi10.1371/journal.pone.0237979
dc.identifier.issn1932-6203
dc.identifier.issue9
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://dx.doi.org/10.1371/journal.pone.0237979
dc.identifier.urihttps://hdl.handle.net/20.500.12511/5916
dc.identifier.volume15
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherPublic Library of Science
dc.relation.ispartofPLOS Oneen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsAttribution 4.0 International*
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/*
dc.subjectGallbladder Polyps
dc.subjectClinicopathologic
dc.subjectUpdated Definitions
dc.titleGallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions
dc.typeArticle

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