Poorly defined diagnostic criteria and often used interchangeably
Etiology/Pathogenesis
• Most occur in setting of cholecystitis or cholelithiasis
Clinical Issues
• Usually incidental finding at time of cholecystectomy
• Benign with no risk of progression to dysplasia or malignancy
• Affects males and females with no age predilection
Macroscopic
• Small polyps, usually < 5 mm in diameter
• May be multiple and sessile or pedunculated
Microscopic
• Prominent hyperplastic mucosal folds and papillae
Mucosa on surface resembles normal gallbladder epithelium
• Metaplastic changes are common
Foveolar, pyloric, &/or intestinal types
• May show focal inflammation, especially at surface
• Reactive epithelial changes may be confused with dysplasia
Papillary Folds and StromaLow-power view of a hyperplastic polyp of the gallbladder illustrates the prominent mucosal folds and papillae with abundant intervening stroma.
Benign Biliary EpitheliumH&E of a hyperplastic polyp at high power shows that the polyp surface is lined by normal-appearing gallbladder mucosa .
Reactive Epithelial ChangesReactive epithelial changes in a hyperplastic polyp include vesicular nuclei and prominent nucleoli associated with inflammation.
Intestinal MetaplasiaMetaplastic changes are very common in hyperplastic polyps. This section shows intestinal-type metaplasia with many goblet cells.
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associated with inflammation.
