Stringer Mark D, Ceylan Haluk, Ward Kate, Wyatt Judy I
Children's Liver & GI Unit, St Jame's University Hospital, Leeds, UK.
J Pediatr Surg. 2003 Nov;38(11):1680-4. doi: 10.1016/s0022-3468(03)00583-9.
Polypoid lesions of the gallbladder (PLG) are rare in childhood. The authors describe 2 additional cases. A 12 year-old-girl was found to have a 5-mm gallbladder polyp during an ultrasound examination for nonspecific abdominal pain. Investigation showed no other biliary tract abnormality. During the next 5 years, she was reviewed periodically with ultrasound scans and underwent cholecystectomy when the diameter of the polyp increased to 1 cm. Histology results showed a benign cholesterol polyp. A 12-year-old-boy was found to have an incidental gallbladder polyp, which 2 years later remained static in size for 10 months. The polyp had disappeared spontaneously. The authors suggest that PLGs in children may be either primary or secondary. Only 11 primary PLGs have been reported, and their histology is variable (adenoma, gastric heterotopia, and epithelial hyperplasia). Secondary PLGs may be found in association with metachromatic leukodystrophy, Peutz-Jeghers syndrome, or pancreato-biliary malunion. The pathologic spectrum of PLGs in children appears to be different from that in adults. For primary PLGs, cholecystectomy is advisable if there are biliary symptoms or if the polyp is > or =1 cm in size. Asymptomatic cases should be maintained under ultrasound surveillance.
胆囊息肉样病变（PLG）在儿童期较为罕见。作者描述了另外2例病例。一名12岁女孩在因非特异性腹痛进行超声检查时发现有一个5毫米的胆囊息肉。检查未发现其他胆道异常。在接下来的5年里，她定期接受超声检查，并在息肉直径增至1厘米时接受了胆囊切除术。组织学结果显示为良性胆固醇息肉。一名12岁男孩偶然发现有胆囊息肉，两年后其大小在10个月内保持稳定，之后息肉自行消失。作者认为儿童的PLG可能是原发性的，也可能是继发性的。仅报道过11例原发性PLG，其组织学表现多样（腺瘤、胃异位及上皮增生）。继发性PLG可能与异染性脑白质营养不良、佩-吉综合征或胰胆管联合畸形有关。儿童PLG的病理谱似乎与成人不同。对于原发性PLG，如果出现胆道症状或息肉大小≥1厘米，建议行胆囊切除术。无症状的病例应在超声监测下随访。
