小野寺 博義¹, 菅原 伸之², 千田 信之³, 小田和 浩一¹, 鵜飼 克明¹

Hiroyoshi ONODERA¹, Nobuyuki SUGAWARA², Nobuyuki CHIDA³, Koichi OTAWA¹, Katsuaki UKAI¹

¹宮城県立がんセンター, ²宮城県対がん協会がん検診センター, ³東北大学医学部第3内科

¹Miyagi Prefectural Cancer Center Hospital, ²Cancer Detection Center of Miyagi Cancer Society, ³The Third Department of Internal Medicine, Tohoku University School of Medicine

キーワード : Follow up Study, Gallbladder Polyp, Cholecystolithiasis, Liver Cyst, Hepatic Hemangioma

A clinical and ultrasonic follow up study was performed on 215 patients with gallbladder polyps, 143 patients with cholecystolithiasis, 170 patients with liver cysts and 98 lesions of hepatic hemangiomas. These lesions were detected in the ultrasonic mass survey conducted by Miyagi Cancer Society. All gallbladder polyps were smaller than 10 mm. The ultrasonographic appearance of gallbladder polyp at the first observation was the typical pattern of cholesterol polyp in 95.3% of cases. Thickening of the gallbladder wall, polypoid lesion in the lumen of gallbladder, the enlargement of gallbladder and the dilatation of the common bile duct were not detected in all cases of cholecystolithiasis. Papillary growth and thickened septum in the lumen were not detected in all cases of liver cyst. Liver cyst was solitary, and measured less than 2 cm in diameter, in 58.8% of the cases. In 83.7% of hemangiomas, ultrasonographic appearance was hyperechoic, sharply marginated and internally homogeneous. Serum liver function tests were normal and HBs-antigen was negative in all patients with hemangioma. Mean observation periods were 44.0 ±25.3, 39.2±23.1, 32.3±20.3 and 42.3±21.8 months for patients with gallbladder polyp, cholecystolithiasis, liver cyst and hemangioma, respectively. Although 40.5% of the cases of gallbladder polyp, 16.1% of the cases of cholecystolithiasis, 21.3% of the cases of liver cyst and 29.6% of the cases of hepatic hemangioma showed the changes in ultrasonographic appearance, no malignancy was discovered in any of cases during follow up observation. Further examinations and follow up observation of patients are not necessary after the discovery of gallbladder polyps, cholecystolithiasis or liver cysts. Short term follow up is necessary in patients with hepatic hemangioma, because it is difficult to differentiate hyperechoic hemangioma from hyperechoic hepatocellular carcinoma.