1,672 results on '"Adenoma, Bile Duct"'
Search Results
2. Volumetric Laser Endomicroscopy's (VLE) Diagnostic Accuracy Validation Study: Impact on Clinical Management Study (VLE-IOV)
- Author
-
NinePoint Medical
- Published
- 2019
3. The Effects of An Addition of Water Enema to PEG for Colon Preparation
- Author
-
Somchai Leelakusolvong, Associate professor
- Published
- 2017
4. Destruction of Residual Endo-biliary Dysplastic Buds After Endoscopic Ampullectomy (endoHPB)
- Author
-
Frederic PRAT, clinical professor
- Published
- 2017
5. Intrahepatic Bile Duct Adenoma Masquerading as Metastatic Carcinoma in a Case of Gastric Carcinoma: a Diagnostic Dilemma
- Author
-
Pallavi Saraf, Jeewan Ram Vishnoi, and Jyotsna Naresh Bharti
- Subjects
medicine.medical_specialty ,business.industry ,Intrahepatic Bile Duct Adenoma ,medicine.medical_treatment ,Carcinoma ,Gastroenterology ,Gastric carcinoma ,Diagnostic dilemma ,Metastatic carcinoma ,Radiation therapy ,Adenoma, Bile Duct ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Oncology ,Internal medicine ,medicine ,Humans ,business - Published
- 2021
6. NRAS-mutated oncocytic benign liver lesion in an organ donor: Pitfalls and troubles in frozen section diagnosis and risk assessment.
- Author
-
Simoncini G, Orsatti A, Malvi D, Tardio ML, Maloberti T, de Biase D, D'Errico A, and Vasuri F
- Subjects
- Male, Humans, Middle Aged, Frozen Sections, Bile Ducts, Intrahepatic pathology, Tissue Donors, Risk Assessment, Membrane Proteins, GTP Phosphohydrolases, Adenoma, Bile Duct, Bile Duct Neoplasms pathology, Liver Neoplasms
- Abstract
Background: In the transplant setting, the definition of the risk of neoplastic transmission from donor to recipient often requires intraoperative pathological evaluation on frozen sections. Although most lesions can be easily classified into acceptable or unacceptable risk according to the Italian National Guidelines, there are cases in which unusual histologic features cannot be further investigated because of the lack of ancillary techniques on frozen sections., Case Presentation: Here we present a case of a liver lesion in a 51-year-old male donor, subjected to histopathological on-call examination. The frozen sections showed a well-demarcated lesion consisting of epithelioid cells disposed in laminar structures and intermingled with a dense lymphocytic population: this led to organ discard with interruption of the donation process. The definitive histological analysis required an extensive immunohistochemical (IHC) investigation: the final diagnosis was "bile duct adenoma with oncocytic features", eventually confirmed by a strongly positive anti-mitochondrial IHC. Finally, an NGS panel analysis was performed, which revealed NRAS mutation., Discussion: To the best of our knowledge, this is the first case of oncocytic bile duct adenoma confirmed by anti-mitochondrial IHC and with NRAS mutation. The most challenging aspect of this case was represented by the transplant setting. In fact, the oncocytic features and the dense lymphocytic infiltrate represented concomitant unusual histological features that led to the halt of the organ donation procedures., Competing Interests: Declaration of Competing Interest I, DEBORAH MALVI, on behalf of all Authors, declare that there are no conflicts of interest to be disclosed concerning the manuscript “NRAS-Mutated oncocytic benign liver lesion in an organ donor: pitfalls and troubles in frozen section diagnosis and risk assessment”., (Copyright © 2023 Elsevier GmbH. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
7. Bile duct adenoma may be a precursor lesion of small duct type intrahepatic cholangiocarcinoma
- Author
-
Yasuni Nakanuma, Motoko Sasaki, and Yasunori Sato
- Subjects
Adult ,Male ,0301 basic medicine ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Histology ,ARID1A ,Pathology and Forensic Medicine ,Cholangiocarcinoma ,Diagnosis, Differential ,03 medical and health sciences ,Adenoma, Bile Duct ,0302 clinical medicine ,Biomarkers, Tumor ,medicine ,Humans ,Bile Duct Adenoma ,Intrahepatic Cholangiocarcinoma ,Aged ,Aged, 80 and over ,business.industry ,Precursor lesion ,Liver Neoplasms ,General Medicine ,Middle Aged ,medicine.disease ,digestive system diseases ,Bile Ducts, Intrahepatic ,030104 developmental biology ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Liver ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,business ,Duct (anatomy) ,Von Meyenburg complexes - Abstract
Precursor lesions of small duct type intrahepatic cholangiocarcinoma (small duct iCCA) have not been clarified so far. We hypothesised that precursor lesions may be frequently distributed in the background liver of small duct iCCA.We determined by histology the presence of bile duct adenomas and von Meyenburg complexes as candidate precursor lesions in the background liver of small duct iCCA, with other primary liver carcinomas as control. Subjects included 28 patients with small duct iCCA, 29 with large duct iCCAs, 60 with combined hepatocellular-cholangiocarcinoma (Comb) and 40 with hepatocellular carcinoma (HCC). The prevalence of bile duct adenomas in the background liver was significantly higher in small duct iCCA (35.7%) compared to other primary liver carcinomas (Comb, 4.9%; 10%, HCC) (P 0.01). The prevalence of bile duct adenomas was significantly associated with the presence of von Meyenburg complexes and ductal plate malformation-like patterns in small duct iCCAs and Combs. Von Meyenburg complexes were detected in 11 small duct iCCA (39.3%), five large duct iCCAs (17.2%), 10 Comb (16.4%) and 13 HCC (33.3%), respectively (P 0.05). Small duct iCCAs showed altered expression of ARID1A (46.4%), p53 (39.3%), PBRM1 (14.3%), IMP3 (85.7%) and EZH2 (82.1%), whereas these markers were negative in bile duct adenomas.Bile duct adenomas may be precursor lesions of small duct iCCAs. Alteration of ARID1A, p53 or PBRM1 may be involved in the carcinogenesis of small duct iCCAs.
- Published
- 2020
8. Common bile duct adenomas: A diagnostic and therapeutic challenge.
- Author
-
Ochoa Segarra F, Sánchez Velázquez P, Grande Posa L, Burdio F, and Ielpo B
- Subjects
- Humans, Common Bile Duct, Bile Ducts, Intrahepatic, Adenoma, Bile Duct, Adenoma diagnosis, Adenoma surgery, Bile Duct Neoplasms diagnosis, Bile Duct Neoplasms surgery
- Published
- 2022
- Full Text
- View/download PDF
9. A Comprehensive Approach to the Management of Benign and Malignant Ampullary Lesions: Management in Hereditary and Sporadic Settings
- Author
-
Jeffrey H. Lee and Donald R. Campbell
- Subjects
medicine.medical_specialty ,Ampulla of Vater ,Biopsy ,Common Bile Duct Neoplasms ,Endoscopic management ,Adenocarcinoma ,Clinical success ,Resection ,Prosthesis Implantation ,03 medical and health sciences ,0302 clinical medicine ,Adenoma, Bile Duct ,medicine ,Humans ,Endoscopic resection ,Duodenoscopy ,business.industry ,Ampullectomy ,General surgery ,Gastroenterology ,General Medicine ,Biliary Tract Surgical Procedures ,Adenomatous Polyposis Coli ,Curative treatment ,030220 oncology & carcinogenesis ,Ampullary Adenoma ,Practice Guidelines as Topic ,030211 gastroenterology & hepatology ,Stents ,business - Abstract
The purpose of this review was to examine the historical roots of endoscopic management of ampullary lesions and explore emerging data on improved techniques, technologies, and outcomes. Of specific interest was answering whether there exists a reasonable body of data to support one resection technique or strategy above others. Review of recent literature suggests the continued use of endoscopic ampullectomy is a safe and effective means of curative treatment of ampullary adenomas. Complications are relatively infrequent and complete endoscopic resection is possible in a majority of cases, with proper patient and lesion selection. Greater than 2 decades of experience with endoscopic ampullectomy have shown this to be a viable, well-tolerated, and highly effective means of treating ampullary adenomas. While few concrete guidelines exist to advise endoscopists on the ideal technique for resection, experience, patient selection, and prior planning can greatly influence the technical and clinical success of endoscopic ampullectomy.
- Published
- 2020
10. Benign focal liver lesions masquerading as primary liver cancers on MRI
- Author
-
Cher Heng Tan, Manickam Subramanian, Hsien Min Low, and Myeong-Jin Kim
- Subjects
Adult ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Adenoma ,Angiomyolipoma ,Liver Abscess ,Contrast Media ,Diagnostic dilemma ,Timely diagnosis ,Granuloma, Plasma Cell ,030218 nuclear medicine & medical imaging ,Adenoma, Liver Cell ,Cholangiocarcinoma ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Adenoma, Bile Duct ,medicine ,Carcinoma ,Humans ,Portasystemic Shunt, Surgical ,Radiology, Nuclear Medicine and imaging ,Abdominal Imaging ,Intrahepatic Cholangiocarcinoma ,Aged ,medicine.diagnostic_test ,Histiocytoma, Benign Fibrous ,business.industry ,Cysts ,Liver Neoplasms ,food and beverages ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,digestive system diseases ,Bile Duct Neoplasms ,Hepatocellular carcinoma ,Needle biopsy ,Female ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Hemangioma ,Splenosis - Abstract
Hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) are the most common primary liver malignancies. HCC and ICC have characteristic imaging findings, but a number of benign entities can appear similar and can cause diagnostic dilemma. Ideally, accurate and timely diagnosis of these conditions can help the patient to avoid a needle biopsy or even unnecessary treatment. In this article, we present various benign liver lesions that display imaging characteristics that are similar to HCC and ICC on magnetic resonance imaging (MRI) and discuss salient features that may assist in accurate diagnosis.
- Published
- 2020
11. Bile duct adenoma: imaging features and radiologic-pathologic correlation
- Author
-
Ryoji, Tatsumi, Shin, Ichihara, Hirokazu, Suii, Masakatsu, Yamaguchi, Tomohiro, Arakawa, Tomoaki, Nakajima, Yasuaki, Kuwata, Itaru, Ozeki, Shuhei, Hige, Joji, Toyota, and Yoshiyasu, Karino
- Subjects
Adult ,Diagnostic Imaging ,Male ,Adenoma, Bile Duct ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Humans ,Middle Aged ,Aged ,Retrospective Studies - Abstract
This study aimed to reveal characteristic imaging features of bile duct adenoma (BDA) by radiologic-pathologic correlation.We retrospectively analyzed pathological and imaging findings of seven patients with BDA.The median maximum diameter of BDA was 5.5 mm. Six lesions had hemispheric morphology. Seven lesions were located in the liver subcapsular region, and proliferation of bile ductules without atypia and fibrous stroma was observed. Two lesions had different microscopic findings. In both lesions, proliferation of bile ductules without atypia was observed in the margin. In one lesion, the percentage of fibrosis and hyalinization was higher at the center than at the margin. In the other lesion, inflammatory cell infiltration was observed in the center. On contrast-enhanced imaging, BDAs showed hypervascularity in the early phase and prolonged enhancement in the delayed phase. On contrast-enhanced multidetector computed tomography during hepatic arteriography, two lesions showed ring-like enhancement in the first phase and prolonged enhancement in the second phase. These were the different histopathologic features of BDAs between the margin and center.Bile duct adenoma can be characterized as a small semicircular lesion located in the liver subcapsular region, which show hypervascularity in the early phase with prolonged enhancement.
- Published
- 2019
12. Imaging features of bile duct adenoma: case series and review of literature
- Author
-
Sudhakar K. Venkatesh, Rondell P. Graham, Wendaline M. VanBuren, Jeffrey A Chuy, and Ishan Garg
- Subjects
Adult ,Image-Guided Biopsy ,Male ,Adenoma ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Adenoma, Bile Duct ,medicine ,Hamartoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Abdominal Imaging ,Bile Duct Adenoma ,Aged ,Retrospective Studies ,Ultrasonography ,medicine.diagnostic_test ,business.industry ,Ultrasound ,Magnetic resonance imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Left hepatic lobe ,Diffusion Magnetic Resonance Imaging ,Bile Duct Neoplasms ,Liver ,030220 oncology & carcinogenesis ,Female ,Tomography ,Cardiology and Cardiovascular Medicine ,business ,Nuclear medicine ,Tomography, X-Ray Computed - Abstract
Purpose We aimed to evaluate the imaging features of bile duct adenoma (BDA) on ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI). Methods Retrospective search in our institution database was performed for histologically confirmed BDA. Their imaging studies before histologic confirmation were reviewed. The search identified seven adults (mean age, 52.9 years) with histologically proven single BDA each. US (n=3), CT (n=5), and MRI (n=3) were performed before histologic confirmation. Additionally, a systematic English literature review for BDA and reported imaging findings since 2000 was also conducted using the following search criteria "bile duct adenoma, peribiliary hamartoma, biliary adenoma, CT, ultrasound, MRI" (date range: 01/01/2000 through 08/31/2016). The imaging findings of those cases reported were summarized and compared with our series. Results All seven individual nodules were well circumscribed. Five lesions were located in the right hepatic lobe and two in the left hepatic lobe. On US, lesions appeared hypoechoic (n=2) and hyperechoic (n=1). BDA was hypodense on unenhanced CT images (n=1). On MRI, BDA were hypointense on T1 (n=3), hyperintense on T2 (n=3), and hyperintense on diffusion-weighted images (n=2). On contrast-enhanced CT and MRI, BDAs showed arterial phase hyperenhancement that persisted on portal venous/delayed phase images. Conclusion BDA demonstrates characteristic arterial phase hyperenhancement that persisted into the portal venous and delayed phases on CT and MRI, which may be useful in differentiating from other hepatic lesions.
- Published
- 2018
13. BRAF V600E mutational status in bile duct adenomas and hamartomas
- Author
-
Elie Serge Zafrani, Claire Castain, Julien Calderaro, Paulette Bioulac-Sage, Cécile Charpy, and Anaïs Pujals
- Subjects
Male ,Proto-Oncogene Proteins B-raf ,Pathology ,medicine.medical_specialty ,Histology ,Hamartoma ,DNA Mutational Analysis ,Pathology and Forensic Medicine ,law.invention ,Adenoma, Bile Duct ,law ,Mutant protein ,Biomarkers, Tumor ,medicine ,Humans ,neoplasms ,Polymerase chain reaction ,Bile Duct Adenoma ,Aged ,Aged, 80 and over ,Bile duct ,business.industry ,General Medicine ,Middle Aged ,Bile duct hamartoma ,medicine.disease ,Immunohistochemistry ,digestive system diseases ,Ductal Plate Malformation ,Bile Ducts, Intrahepatic ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Female ,business ,V600E - Abstract
Aims Bile duct adenomas (BDA) and bile duct hamartomas (BDH) are benign bile duct lesions considered neoplastic or secondary to ductal plate malformation, respectively. We have reported previously a high prevalence of BRAF V600E mutations detected by allele-specific polymerase chain reaction assay in BDA, and suggested that BDA may be precursors to a subset of intrahepatic cholangiocarcinomas harbouring V600E mutations. The aim of the present study was to assess the existence of BRAF V600E mutations, using immunohistochemical methods, in additional BDA as well as in BDH. Methods and results Fifteen BDA and 35 BDH were retrieved from the archives of the pathology departments of two French university hospitals. All cases were reviewed by two pathologists specialized in liver diseases. BRAF V600E mutational status was investigated by immunohistochemistry. Mutated BRAF mutant protein was detected in 53% of the BDA and in none of the cases of BDH. Conclusion Our findings suggest that BDA and BDH are different processes, and that BDA represent true benign neoplasms. They also support the hypothesis that mutated BDA might precede the development of the subset of intrahepatic cholangiocarcinomas harbouring BRAF V600E mutations.
- Published
- 2015
14. Magnetic Resonance Imaging Findings of Intrahepatic Bile Duct Adenoma
- Author
-
Wenjie Liang and Shunliang Xu
- Subjects
Adult ,Male ,medicine.medical_specialty ,Intrahepatic Bile Duct Adenoma ,Contrast Media ,Bile Duct Neoplasm ,Diagnosis, Differential ,Young Adult ,Adenoma, Bile Duct ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Delayed phase ,Middle Aged ,Image Enhancement ,medicine.disease ,Magnetic Resonance Imaging ,Hyperintensity ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Hepatocellular carcinoma ,Female ,Radiology ,Neoplasm Recurrence, Local ,Differential diagnosis ,business ,Follow-Up Studies ,Arterial phase - Abstract
Intrahepatic bile duct adenoma (BDA) is a rare type of benign hepatic lesions. In this study, 4 cases of BDA diagnosed from surgical resection pathology were examined. Their clinical and magnetic resonance imaging (MRI) data were retrospectively analyzed. The 4 cases (1 men and 3 women) were aged 21 to 55 years without obvious clinical symptoms. Three were identified through routine examination. Three had a history of chronic hepatitis B virus infection. Two cases were accompanied by hepatocellular carcinoma, and one had a higher level of α-fetoprotein. The MRI images of BDA all manifested as peripheral hepatic nodules with abnormal signals. The diameters of the lesions in the 4 cases were 7.7 to 17.0 mm. The MRI images showed slight hypointensity on T1WI and slight hyperintensity on T2WI in all cases, and they showed slight hyperintensity in 2 cases and hyperintensity in 2 cases on diffusion-weighted imaging. Dynamic contrast-enhanced MRI scans show hyperintensity in the arterial phase and slight hyperintensity in the late stage in 3 cases. The other case shows hyperintensity in the arterial and portal phases and isointensity at the delayed phase. During follow-up, 3 cases were recurrence-free. The other case was complicated by the reoccurrence of HCC. In general, BDA shows specific MRI characteristics, and peripheral hepatic nodules show slight hypointensity on T1WI and slight hyperintensity on T2WI. Dynamic contrast-enhanced MRI scans showed obvious enhancement in the arterial phase and continuous enhancement at the late stage.
- Published
- 2015
15. Expression and Significance of COX-2 and Ki-67 in Hepatolithiasis with Bile Duct Carcinoma
- Author
-
Beiwang Sun, Yanmin Liu, Yu He, Canhua Zhu, Xiaodong Ma, Binyuan Huang, and Ping Wang
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Bile Duct Neoplasm ,Lithiasis ,Bile Duct Carcinoma ,Gene Expression Regulation, Enzymologic ,Metastasis ,Cohort Studies ,Adenoma, Bile Duct ,Clinical Research ,medicine ,Carcinoma ,Humans ,Aged ,Cyclooxygenase 2 Inhibitors ,biology ,Bile duct ,Gene Expression Profiling ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Immunohistochemistry ,Gene Expression Regulation, Neoplastic ,Ki-67 Antigen ,Treatment Outcome ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Cyclooxygenase 2 ,Ki-67 ,biology.protein ,Regression Analysis ,Female ,Bile Ducts ,Hepatolithiasis - Abstract
Background As an induced enzyme, COX-2 expression is elevated under stimuli from inflammatory mediator or growth factor product. Ki-67, a cell cycle-related proliferative antigen, reflects the tissue proliferative activity. This study analyzed the expressional profile of cyclooxygenase-2 (COX-2) and Ki-67 in hepatolithiasis and bile duct carcinoma tissues, in an attempt to provide evidence for diagnosis and prognosis prediction of disease. Material and methods A cohort of tissue samples from hepatolithiasis with bile duct carcinoma (N=47) patients were analyzed using immunohistochemical (IHC) staining method for the expression of COX-2 and Ki-67, in parallel with hepatolithiasis (N=44) and normal bile duct tissues (N=30). The relationship between expression pattern of COX-2 and Ki-67 and pathological conditions was also analyzed, in addition to the correlation with positive expression in hepatolithiasis samples. Results The positive expression rate of COX-2 and Ki-67 in bile duct carcinoma was 76.6% and 80.9%, respectively, and was significantly higher than those in the hepatolithiasis group, which was also higher than the control group. Expression of both COX-2 and Ki-67 is closely related to TNM staging, lymph node metastasis, and differentiation stage. They were also correlated with the mortality rate of patients. Conclusions Both COX-2 and Ki-67 are abundantly expressed in hepatolithiasis and bile duct carcinoma tissues and may play an important role in the disease occurrence, progression, and metastasis.
- Published
- 2015
16. Immunostaining for Polycomb Group Protein EZH2 and Senescent Marker p16INK4a May Be Useful to Differentiate Cholangiolocellular Carcinoma From Ductular Reaction and Bile Duct Adenoma
- Author
-
Yasuni Nakanuma, Yuko Kakuda, Yasunori Sato, Takashi Matsubara, and Motoko Sasaki
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Adenoma ,Biopsy ,digestive system ,Pathology and Forensic Medicine ,Benign tumor ,Cholangiocarcinoma ,Diagnosis, Differential ,Adenoma, Bile Duct ,Predictive Value of Tests ,Biomarkers, Tumor ,medicine ,Humans ,Enhancer of Zeste Homolog 2 Protein ,Cellular Senescence ,Cyclin-Dependent Kinase Inhibitor p16 ,Intrahepatic Cholangiocarcinoma ,Bile Duct Adenoma ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Polycomb Repressive Complex 2 ,Middle Aged ,medicine.disease ,Immunohistochemistry ,digestive system diseases ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Female ,Surgery ,Anatomy ,Differential diagnosis ,business ,Immunostaining - Abstract
Intrahepatic cholangiocarcinoma arising in chronic advanced liver disease sometimes contains a component of cholangiolocellular carcinoma. Bile duct adenoma, a benign tumor/tumorous lesion and ductular reaction, is also composed of bile ductular cells, and the differential diagnosis is sometimes difficult. We have previously reported that cholangiolocellular carcinoma showed overexpression of a polycomb group protein EZH2, which participates in bypass/escape from cellular senescence during carcinogenesis. In contrast, the ductular reaction showed high expression of senescence-associated p16(INK4a). In this study, we examined whether immunostaining for EZH2 and p16(INK4a) is useful for differential diagnosis among cholangiolocellular carcinoma, bile duct adenoma, and ductular reactions. Subjects included 33 patients with intrahepatic cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma with components of cholangiolocellular carcinoma and 16 patients with bile duct adenoma. The expressions of EZH2 and p16(INK4a) were examined immunohistochemically. The expression of EZH2 was seen in all cases of cholangiolocellular carcinomas, but it was not observed in bile duct adenomas and ductular reactions, which were seen around carcinomas in 80% of cases. The extensive expression of p16(INK4a) was seen only in 4 cases of cholangiolocellular carcinomas (12%). In contrast, the expression of p16(INK4a) was seen in 13 cases (81%) of bile duct adenomas and in all cases of ductular reactions. The borderline between the component of cholangiolocellular carcinoma and the surrounding ductular reaction was clearly highlighted by the reverse expression pattern of EZH2 and p16(INK4a) in 69% of cases. In conclusion, immunostaining for EZH2 and p16(INK4a) may be useful for differential diagnosis among cholangiolocellular carcinomas, bile duct adenomas, and ductular reactions.
- Published
- 2014
17. A Rare Case of Incidental Common Bile Duct Adenoma-Endoscopic Ultrasound Evaluation
- Author
-
Valerieva, Yana, Lutakov, Ivan, Golemanov, Branimir, Jelev, Georgi, and Vladimirov, Borislav
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Adenoma ,lcsh:Medicine ,Bile Duct Neoplasm ,03 medical and health sciences ,Adenoma, Bile Duct ,0302 clinical medicine ,Rare case ,medicine ,Humans ,Aged, 80 and over ,Common Bile Duct ,medicine.diagnostic_test ,Common bile duct ,business.industry ,Adenoma bile duct ,lcsh:R ,General Medicine ,medicine.disease ,Bile Ducts, Intrahepatic ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Clinical Image ,030220 oncology & carcinogenesis ,Female ,030211 gastroenterology & hepatology ,Radiology ,business - Published
- 2018
18. Intrahepatic Bile Duct Adenoma Mimicking Hepatic Metastasis: Case Report and Review of the Literature
- Author
-
Masayuki Nakajo, Yoshihiko Fukukura, Kohei Nagasato, Shoji Natsugoe, Koji Takumi, and Michiyo Higashi
- Subjects
medicine.medical_specialty ,Adenoma ,Intrahepatic Bile Duct Adenoma ,Diagnosis, Differential ,Adenoma, Bile Duct ,Stomach Neoplasms ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Bile Duct Adenoma ,Aged ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Cancer ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,Hepatic metastasis ,digestive system diseases ,Hyperintensity ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Female ,Radiology ,business ,Superparamagnetic iron oxide - Abstract
We present a case of bile duct adenoma that mimicked hepatic metastasis from gastric cancer. The adenoma exhibited prolonged enhancement on dynamic computed tomography, hyperintensity on diffusion-weighted imaging, and diminished uptake of superparamagnetic iron oxide and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid on magnetic resonance imaging, resembling those of adenocarcinomas. Knowledge of the imaging findings of this rare entity may aid correct diagnosis.
- Published
- 2013
19. BRAF V600E mutation in biliary proliferations associated with α
- Author
-
Napat, Angkathunyakul, Francesca, Rosini, Nigel, Heaton, Pierre, Foskett, and Alberto, Quaglia
- Subjects
Cholangiocarcinoma ,Male ,Proto-Oncogene Proteins B-raf ,Adenoma, Bile Duct ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,alpha 1-Antitrypsin Deficiency ,DNA Mutational Analysis ,Mutation ,Humans ,Female ,Middle Aged ,Immunohistochemistry - Abstract
Both homozygous and heterozygous αEleven biliary lesions from five AAT deficiency patients (six BDAs from three cirrhotic patients with other concurrent liver diseases; three BDAs and two ICCs from two non-cirrhotic patients) were identified between 2010 and 2015 during routine histological investigation. Most BDAs expressed CD56, EpCAM, CD133, and CA19-9, similarly to hepatic progenitor cells (HPCs), and carried the BRAF V600E mutation (87.5%). One ICC showed a similar immunohistochemical profile but no evidence of the BRAF V600E mutation.Most of the biliary proliferations in AAT deficiency patients have an appearance of BDA with an HPC-related immunohistochemical profile. Their frequent BRAF V600E mutations support their neoplastic nature, but not necessarily their progression to ICC. We believe that this may depend on the patient genotype, or require a different pathway or a second mutational hit for malignant transformation. We postulate that BDA represents a heterogeneous group of biliary lesions, and that those associated with AAT deficiency may constitute a group of their own.
- Published
- 2016
20. Detection of hepatitis B virus DNA in paraffin-embedded intrahepatic and extrahepatic cholangiocarcinoma tissue in the northern Chinese population
- Author
-
Xiaohui Bai, Ran Zhao, Tianzhen Wang, Yiqi Wu, Shengqian Ye, Xiaoming Jin, Kenji Abe, and Yingying Wu
- Subjects
Male ,China ,Hepatitis B virus ,Pathology ,medicine.medical_specialty ,medicine.disease_cause ,digestive system ,Virus ,Pathology and Forensic Medicine ,Pathogenesis ,Adenoma, Bile Duct ,Antigen ,medicine ,Humans ,neoplasms ,Intrahepatic Cholangiocarcinoma ,Paraffin Embedding ,business.industry ,Middle Aged ,Hepatitis B ,medicine.disease ,Virology ,digestive system diseases ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,DNA, Viral ,Immunohistochemistry ,Female ,business ,Nested polymerase chain reaction - Abstract
This study explored the importance of hepatitis B virus infection in cholangiocarcinoma pathogenesis in northern China. The clinical data of 66 patients with cholangiocarcinoma were analyzed. The hepatitis B virus gene was amplified using nested polymerase chain reaction, and the hepatitis B virus-related antigen was detected using immunohistochemistry in formalin-fixed, paraffin-embedded tissue from patients with intrahepatic cholangiocarcinoma (n = 23) and extrahepatic cholangiocarcinoma (n = 43). Hepatitis B surface antigen seropositivity was found in 52.2% (12/23) of intrahepatic cholangiocarcinoma cases and 13.9% (6/43) of extrahepatic cholangiocarcinoma cases. Hepatitis B virus DNA (X region) was detectable in 34.8% (8/23) of intrahepatic cholangiocarcinoma cases. Hepatitis B surface antigen and/or hepatitis B core antigen was detectable in 30.4% (7/23) of intrahepatic cholangiocarcinoma cases. All cases with detected viral protein were also positive for hepatitis B virus DNA. In contrast, no hepatitis B virus antigens or hepatitis B virus gene was detected in any of the 43 extrahepatic cholangiocarcinoma cases. Our findings strongly suggest that chronic hepatitis B virus infection is a significant risk factor for intrahepatic cholangiocarcinoma, but not for extrahepatic cholangiocarcinoma, in northern China. Hepatitis B virus infection is potentially independently associated with intrahepatic cholangiocarcinoma.
- Published
- 2012
21. Hepatocellular and Cholangiolar Carcinoma-Derived Cell Lines Reveal Distinct Sets of Chromosomal Imbalances
- Author
-
Sabine Glombitza, Caroline Hammer, Ludwig Wilkens, and Dominique-Elisabeth Muller
- Subjects
medicine.medical_specialty ,Carcinoma, Hepatocellular ,Aneuploidy ,Biology ,medicine.disease_cause ,Pathology and Forensic Medicine ,Cholangiocarcinoma ,Adenoma, Bile Duct ,Cell Line, Tumor ,medicine ,Carcinoma ,Humans ,Molecular Biology ,In Situ Hybridization, Fluorescence ,Chromosome Aberrations ,Comparative Genomic Hybridization ,Chromosomes, Human, Pair 13 ,medicine.diagnostic_test ,Liver Neoplasms ,Cytogenetics ,Cell Biology ,General Medicine ,medicine.disease ,Molecular biology ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Chromosomes, Human, Pair 1 ,Cell culture ,Ploidy ,Carcinogenesis ,Chromosomes, Human, Pair 17 ,Chromosomes, Human, Pair 8 ,Fluorescence in situ hybridization ,Comparative genomic hybridization - Abstract
Objectives: Hepatocellular carcinoma (HCC) and cholangiolar carcinoma (CC) cell lines are used to analyze the basic mechanisms of carcinogenesis and target therapies. However, it is not yet clear which chromosomal aberrations are to be typically expected in such cell lines. It is also not clear whether there are prerequisites for in vitro growth on the genomic and/or expression level. We therefore analyzed HCC and CC cell lines for typical genetic settings. Methods: The HCC cell lines HLE, HLF, Huh7, HepG2 and Hep3b and the CC cell lines EGI1, MzCha1 and TFK-1 were analyzed using high-density arrays for comparative genomic hybridization (aCGH; 244,000 oligonucleotides). Additional fluorescence in situ hybridization analyses were done to confirm the aCGH results and to add information regarding the aneuploidy of cell lines. Results: The gain of 1q, in particular q21-22, was detected in all HCC cell lines also as a partial loss of 13q. In contrast, a loss of 8p in combination with a relative gain of 8q was seen in all CC but no HCC cell lines. Interestingly, a gain of 17q was seen in all cell lines. These aberrations are also well documented for surgical tumor specimens. Besides these imbalances, the cell lines revealed imbalances for 11p, 12p, 14q, 16p, 16q, 21q and 22q, respectively, only rarely seen in surgical tumor specimens. These aberrations could be of importance for the in vitro cultivation of tumor cells. Structural aberrations were accompanied by aneuploidy in 3 of 5 HCC cell lines and 2 of 3 CC cell lines. Ploidy status was not correlated to any of the imbalances mentioned above. Conclusions: HCC and CC cell lines revealed characteristic chromosomal imbalances similar to those seen in surgical tumor specimens including chromosomes 1, 8, 13 and 17, respectively. These aberrations are characteristic of the histogenetic origin of the tumor cells. However, the chromosomal imbalances that occurred probably led to the ability of tumor cells to grow in vitro.
- Published
- 2012
22. Albumin expression distinguishes bile duct adenomas from metastatic adenocarcinoma
- Author
-
Vikram Deshpande, Kshitij S. Arora, and Andrea P. Moy
- Subjects
0301 basic medicine ,Adult ,Male ,Proto-Oncogene Proteins B-raf ,Pathology ,medicine.medical_specialty ,Histology ,Metastatic adenocarcinoma ,In situ hybridization ,Adenocarcinoma ,Sensitivity and Specificity ,Pathology and Forensic Medicine ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Adenoma, Bile Duct ,Albumins ,medicine ,Biomarkers, Tumor ,Humans ,Bile Duct Adenoma ,In Situ Hybridization ,Aged ,Retrospective Studies ,Bile duct ,business.industry ,Albumin ,General Medicine ,Metastatic Pancreatic Adenocarcinoma ,Middle Aged ,digestive system diseases ,Staining ,Pancreatic Neoplasms ,030104 developmental biology ,medicine.anatomical_structure ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Tissue Array Analysis ,030220 oncology & carcinogenesis ,Immunohistochemistry ,Female ,business ,Carcinoma, Pancreatic Ductal - Abstract
AIMS Bile duct adenomas may be difficult to distinguish from metastatic carcinomas, particularly well-differentiated pancreatic ductal adenocarcinoma. Prior studies have evaluated the utility of various immunohistochemical markers, although these markers are notable for low sensitivity and/or specificity. The aim of this study was to investigate the utility of albumin and BRAFV600E expression in distinguishing between metastatic pancreatic adenocarcinoma and bile duct adenoma. METHODS AND RESULTS We studied 26 bile duct adenomas, three bile duct hamartomas, and 158 pancreatic ductal adenocarcinomas. Branched-chain in-situ hybridization (bISH) for albumin was performed; bISH is based on the branched DNA technology, wherein signal amplification is achieved via a series of sequential steps. Additionally, BRAFV600E immunohistochemistry (IHC) was performed on a subset of cases. Twenty-three of 25 (92%) bile duct adenomas were positive for albumin; 18 (72%) showed diffuse staining, and five showed focal staining (20%), including two challenging examples. Two bile duct hamartomas also stained positively. All pancreatic adenocarcinomas were negative for albumin. Seven of 16 (44%) bile duct adenomas and five of 106 (5%) pancreatic ductal adenocarcinomas were positive for BRAFV600E by IHC. The sensitivity and specificity of expression of albumin, as detected by bISH, for distinguishing bile duct adenomas from metastatic pancreatic adenocarcinomas were 92% and 100%, respectively; the sensitivity and specificity of BRAFV600E IHC for distinguishing bile duct adenomas from metastatic pancreatic adenocarcinomas were 43.8% and 95.3%, respectively. CONCLUSIONS Diagnostically challenging examples of bile duct adenoma may be distinguished from metastatic pancreatic adenocarcinoma by the use of albumin bISH.
- Published
- 2015
23. Imaging Findings of Intrahepatic Bile Duct Adenoma (Peribiliary Gland Hamartoma): a Case Report and Literature Review
- Author
-
Jae Young Byun, Seung Eun Jung, Dong Goo Kim, Eun Sun Jung, You Sung Kim, Soon Nam Oh, Sung Eun Rha, Byung Gil Choi, and Yu Ri Shin
- Subjects
Adenoma ,medicine.medical_specialty ,Intrahepatic Bile Duct Adenoma ,Hamartoma ,Contrast Media ,Case Report ,Adenoma, Bile Duct ,medicine ,Hepatectomy ,Humans ,Radiology, Nuclear Medicine and imaging ,Computed tomography (CT) ,Bile Duct Adenoma ,Tumor size ,Bile duct ,business.industry ,Magnetic resonance (MR) ,Cystic Change ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Liver ,Bile Duct Neoplasms ,Female ,Radiology ,Differential diagnosis ,business ,Tomography, X-Ray Computed - Abstract
Intrahepatic bile duct adenoma is a rare benign epithelial hepatic tumor derived from bile duct cells. We report the imaging findings of a patient with bile duct adenoma, which appeared as a small heterogeneously enhancing mass with focal small cystic change on CT and MRI. Follow-up images at seven months showed a slight increase in tumor size, which could be partly explained by intratumoral hemorrhage on pathologic examination. Although rare, bile duct adenoma should be considered as a differential diagnosis of a small hypervascular tumor located in the periphery of liver. Focal cystic change and intratumoral hemorrhage may occur.
- Published
- 2010
24. Complete en bloc resection of a large ampullary adenoma with a focal adenocarcinoma by using endoscopic submucosal dissection (with video)
- Author
-
Hidetoshi Nakano, Hiromi Fukushima, Kiichi Tamada, Hironori Yamamoto, Katsuyuki Nakazawa, Kentaro Sugano, Keijiro Sunada, and Shinichi Wada
- Subjects
Adenoma ,Surgical resection ,Ampulla of Vater ,medicine.medical_specialty ,Adenocarcinoma ,Risk Assessment ,Diagnosis, Differential ,Adenoma, Bile Duct ,Duodenal Neoplasms ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Radiology, Nuclear Medicine and imaging ,Intestinal Mucosa ,Duodenoscopy ,Aged ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,En bloc resection ,Endoscopy ,Endoscopic submucosal dissection ,medicine.disease ,Surgery ,Cell Transformation, Neoplastic ,Treatment Outcome ,Ampullary Adenoma ,Female ,business ,Follow-Up Studies - Published
- 2009
25. TUMOUR INDUCTION IN SYRIAN HAMSTERS FED A COMBINATION OF AMINOPYRINE AND NITRIT
- Author
-
Frank Bergman and T. Wahlin
- Subjects
Male ,medicine.medical_specialty ,Lung Neoplasms ,Sodium ,Intrahepatic bile ducts ,chemistry.chemical_element ,Chenodeoxycholic Acid ,chemistry.chemical_compound ,Adenoma, Bile Duct ,Cricetinae ,Internal medicine ,Chenodeoxycholic acid ,medicine ,Animals ,Aminopyrine ,Nitrites ,Syrian hamsters ,Carcinogen ,Mesocricetus ,Sodium Nitrite ,Tumour induction ,General Medicine ,Bile Ducts, Intrahepatic ,Endocrinology ,Bile Duct Neoplasms ,chemistry ,Female - Abstract
Hamsters fed a aminopyrine/sodium nitrit mixture in drinking water showed a high incidence of intrahepatic bile duct tumours. Chenodeoxycholic acid was not found to have any promoting effect on the liver carcinogenicity induced by this combination of aminopyrine and sodium nitrit in hamsters.
- Published
- 2009
26. CIRRHOSIS AND MALIGNANT HEPATOMA IN α1-ANTITRYPSIN DEFICIENCY
- Author
-
Inga Hägerstrand and Sten Eriksson
- Subjects
Liver Cirrhosis ,Male ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Cirrhosis ,Inclusion bodies ,Adenoma, Bile Duct ,Liver Function Tests ,Antigen ,Internal Medicine ,medicine ,Humans ,Aged ,Subclinical infection ,business.industry ,Liver Neoplasms ,Blood Proteins ,Middle Aged ,medicine.disease ,Phenotype ,α1 antitrypsin ,Liver ,alpha 1-Antitrypsin ,Concomitant ,Etiology ,Portal hypertension ,Female ,Autopsy ,business ,Metabolism, Inborn Errors - Abstract
Clinical and laboratory findings in 9 adults with homozygous (Pizz) α1-antitrypsin (AAT) deficiency and cirrhosis of the liver are described. This clinical entity is characterized by rapidly progressive cirrhosis in non-alcoholics above 50 years of age, resulting in severe portal hypertension and death in hepatic coma or bleeding. Concomitant emphysema, often subclinical, is usually present and malignant hepatoma is common. Histologically typical PAS-positive inclusion bodies are always demonstrable. Cholestatic features are not prominent. The entity is not associated with the HAA antigen, and serum “auto-antibodies” are lacking. In addition to AAT deficiency the serum protein analysis reveals the pattern seen in cirrhosis of other etiology, but in most cases the IgM level was unusually high. The pathogenetic mechanism leading to cirrhosis in a minority, at most 10% of adult patients with the Pizz phenotype remains obscure.
- Published
- 2009
27. The expression of p53 antigen in primary malignant epithelial tumors of the liver: an immunohistochemical study
- Author
-
Prodromos Hytiroglou, Doo Ho Park, Swan N. Thung, Neil D. Theise, Stephen A. Geller, Sang Wook Choi, Sun Moo Kim, and Kyu Won Chung
- Subjects
Male ,Hepatoblastoma ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Mutant ,Biology ,Adenoma, Bile Duct ,Antigen ,medicine ,Carcinoma ,Humans ,Aged ,Hepatology ,Epithelioma ,Liver Neoplasms ,Middle Aged ,Hepatitis B ,medicine.disease ,digestive system diseases ,Gene Expression Regulation, Neoplastic ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Child, Preschool ,Hepatocellular carcinoma ,Cancer research ,Immunohistochemistry ,Female ,Tumor Suppressor Protein p53 - Abstract
— We examined the expression of mutant p53 gene products in primary malignant epithelial tumors of the liver. Fourteen of 68 hepatocellular carcinomas, one of seven hepatoblastomas and one of nine intrahepatic cholangiocarcinomas showed nuclear staining for p53 proteins. None of the surrounding non-tumorous tissues expressed nuclear staining. The detection of p53 proteins in tumor cells was significantly higher in hepatocellular carcinomas of Oriental patients (31.6%) compared to non-Orientals (6.7%, p
- Published
- 2008
28. Simultaneous detection of epidermal growth factor receptor (EGF-R), epidermal growth factor (EGF) and ras p21 in cholangiocarcinoma by an immunocytochemical method
- Author
-
Goroku Ohta, Yasuni Nakanuma, Nobutatsu Takayanagi, Kishichiro Watanabe, Morimoto Hayashi, Akitaka Nonomura, Yuji Mizukami, Fujitsugu Matsubara, and Ryohei Izumi
- Subjects
Male ,Immunoenzyme Techniques ,Proto-Oncogene Proteins p21(ras) ,Adenoma, Bile Duct ,Antigen ,Epidermal growth factor ,Proto-Oncogene Proteins ,Humans ,Epidermal growth factor receptor ,Receptor ,Autocrine signalling ,Gene ,Intrahepatic Cholangiocarcinoma ,Aged ,Epidermal Growth Factor ,Hepatology ,biology ,Membrane Proteins ,Middle Aged ,ErbB Receptors ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,biology.protein ,Cancer research ,Female ,Antibody ,hormones, hormone substitutes, and hormone antagonists - Abstract
— Expression of the epidermal growth factor (EGF), EGF receptor (EGFR) and ras oncogene product p21 was simultaneously examined in 37 cases with intrahepatic cholangiocarcinoma (CC) by means of an immunocytochemical method. While normal livers were all negative for any of the antigens at the concentration of the antibodies used, EGF-R was positive in 12 (32.4%) CCs, EGF in 22 (59.5%), and ras p21 in 33 (89.2%). The positive incidence of the three antigens was not different among the histologic subtypes of the tumor. However, the number of EGF-R- and ras p21-positive tumor cells decreased with progressing histologic tumor grade, but the expression of EGF was not associated with the tumor grade. Expression of the three antigens was not related to the degree of metastatic spread of the tumor. Simultaneous expression of the three antigens was seen only in 4 CCs, and that of EGF-R and EGF in 4, EGF-R and ras p21 in 12, and EGF and ras p21 in 20. These data suggest that the expression of EGF, EGF-R and ras p21 on CC cells is not related to the tumor aggressiveness, and the activation of each respective gene is independent. Furthermore, the data also indicate that an autocrine model for tumor growth, as suggested by a combination of EGF and EGF-R, may be applicable only to very limited cases of CCs.
- Published
- 2008
29. Solitary hilar biliary adenoma: MR imaging and MR cholangiography features with pathologic correlation
- Author
-
Piero Boraschi, Francescamaria Donati, Alessia Volpi, and L.E. Pollina
- Subjects
medicine.medical_specialty ,Adenoma ,Cholangiopancreatography, Magnetic Resonance ,Bile Duct Epithelium ,Lumen (anatomy) ,Adenoma, Bile Duct ,Cholangiography ,Pathologic correlation ,Humans ,Medicine ,Aged ,Cholangiopancreatography, Endoscopic Retrograde ,Hepatology ,medicine.diagnostic_test ,business.industry ,Bile duct ,Gastroenterology ,Magnetic resonance imaging ,Biliary adenoma ,equipment and supplies ,medicine.disease ,Magnetic Resonance Imaging ,Bile Ducts, Intrahepatic ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Female ,Radiology ,business ,human activities - Abstract
Biliary adenoma is a rare tumour characterized by the proliferation of bile duct epithelium into the lumen. Diagnosis is usually based on the imaging findings of bile duct dilatation and intraductal mass. We describe previously un-reported magnetic resonance imaging and magnetic resonance cholangiography features with endoscopic retrograde cholangiography and pathologic correlation of a solitary hilar biliary adenoma.
- Published
- 2007
30. Benign nodules mimicking hepatocellular carcinoma on gadoxetic acid-enhanced liver MRI
- Author
-
Kyoung Doo Song and Woo Kyoung Jeong
- Subjects
Adult ,Gadolinium DTPA ,Male ,Gadoxetic acid ,Pathology ,medicine.medical_specialty ,Angiomyolipoma ,Carcinoma, Hepatocellular ,Adenoma ,Bile Duct Neoplasm ,Diagnosis, Differential ,Adenoma, Bile Duct ,Pseudolymphoma ,medicine ,Humans ,lcsh:RC799-869 ,Molecular Biology ,Bile Duct Adenoma ,Aged ,Hepatology ,business.industry ,Liver Diseases ,Liver Neoplasms ,Hepatocelluar carcinoam ,Mimicker ,Liver Imaging ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,Bile duct adenoma ,digestive system diseases ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Hepatocellular carcinoma ,lcsh:Diseases of the digestive system. Gastroenterology ,Female ,Radiology ,Differential diagnosis ,business ,Tomography, X-Ray Computed ,medicine.drug - Abstract
Although diagnostic accuracy of imaging techniques for HCC has been improved through recent advances in MR techniques and new hepatocyte-specific contrast agents, misdiagnosis is encountered not uncommonly in real clinical practice. To reduce the rate of misdiagnosis, doctors should be familiar with the clinical manifestation and the imaging findings of false positive and false negative cases. We here report three cases with benign hepatic nodules mimicking HCC: bile duct adenoma, angiomyolipoma and pseudolymphoma.
- Published
- 2015
31. Reply to Letter to the Editor by Pujals et al
- Author
-
Yuki Tanaka, Yuichiro Kubo, Ken Shirabe, Yoshinao Oda, Shinichi Aishima, and Yoshihiko Maehara
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Letter to the editor ,Philosophy ,Hamartoma ,General Medicine ,Pathology and Forensic Medicine ,Hepatitis ,Adenoma, Bile Duct ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,medicine ,Humans ,Female ,Theology - Published
- 2015
32. Relapsing acute pancreatitis due to ampullary adenoma in a patient with familial adenomatous polyposis
- Author
-
Takeshi Sudo, Yoshiaki Murakami, Taijiro Sueda, Kenichiro Uemura, and Yasuo Hayashidani
- Subjects
Adult ,Ampulla of Vater ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Abdominal pain ,Common Bile Duct Neoplasms ,Gastroenterology ,Pancreaticoduodenectomy ,Familial adenomatous polyposis ,Adenoma, Bile Duct ,Recurrence ,Internal medicine ,medicine ,Humans ,Duodenoscopy ,Stage (cooking) ,business.industry ,Hepatology ,medicine.disease ,digestive system diseases ,Colorectal surgery ,Adenomatous Polyposis Coli ,Pancreatitis ,Acute Disease ,Acute pancreatitis ,Female ,medicine.symptom ,business ,Abdominal surgery - Abstract
A patient with familial adenomatous polyposis (FAP) presented with a relapsing attack of acute pancreatitis. Evaluation using computed tomography, ultrasonography, and duodenoscopy revealed an ampullary adenoma, which was classified as Spigelman's stage III according to Spigelman's criteria. The patient underwent a pylorus-resected pancreatoduodenectomy, and has had no abdominal pain suggesting acute pancreatitis for 1 year after surgery. Only a few reports of acute pancreatitis due to ampullary neoplasms in patients with FAP are available. Relapsing acute pancreatitis is another surgical indication for premalignant periampullary neoplasms in FAP.
- Published
- 2006
33. Immunohistochemical Analysis of Biliary Tract Lesions
- Author
-
Asli Yilmaz, Cynthia Behling, Barry R De Young, Guangming Tan, Amy Lehman, and Wendy L. Frankel
- Subjects
Pathology ,medicine.medical_specialty ,Histology ,Proliferation index ,Adenoma ,Cholangitis ,Bile Duct Diseases ,Pathology and Forensic Medicine ,Cholangiocarcinoma ,Lesion ,Adenoma, Bile Duct ,medicine ,Carcinoma ,Humans ,Bile Duct Adenoma ,Bile duct ,business.industry ,medicine.disease ,Immunohistochemistry ,Medical Laboratory Technology ,Bile Ducts, Intrahepatic ,Ki-67 Antigen ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Proto-Oncogene Proteins c-bcl-2 ,Biliary tract ,Tumor Suppressor Protein p53 ,medicine.symptom ,business - Abstract
The distinction among inflammatory, benign, and malignant lesions of the biliary tract can at times be difficult. Several methods have been used, including immunohistochemistry (IHC), with variable success. We evaluated a panel of IHC stains to determine their utility in discriminating between bile duct lesions. Formalin-fixed, paraffin-embedded 4-microm sections from 12 inflammatory lesions, 10 bile duct adenomas, and 13 bile duct carcinomas were immunostained using a modified avidin-biotin-complex technique after epitope enhancement using antibodies for p53, Ki-67, and bcl-2. For p53 and bcl-2, greater than 1% of cells staining positive was interpreted as positive. The proliferation index was calculated by determining the number of Ki-67-positive cells in a 1000 cell count. In the inflammatory group, 0 of 12 reacted with anti-p53, 2 of 12 were positive with anti-bcl-2, and the proliferation index with was 22.9% +/- 3.9%. Two of 10 bile duct adenomas showed reactivity with anti-bcl-2, and none were decorated with anti-p53 or Ki-67. In the carcinoma group, 6 of 13 were positive with anti-p53, 9 of 12 were positive with anti-bcl-2, and the proliferation index was 35.3% +/- 5.5%. The proliferation rates differed significantly between groups (P < 0.05). The presence of bcl-2 and p53 immunoreactivity coupled with a high proliferative rate in a biliary tract lesion suggests a malignant process. A panel using these antibodies may be useful in difficult cases.
- Published
- 2004
34. Endoscopic papillary balloon dilation causes transient pancreatobiliary and duodenobiliary reflux
- Author
-
Masanori Sugiyama and Yutaka Atomi
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adenoma ,Balloon ,Catheterization ,Adenoma, Bile Duct ,medicine ,Bile ,Humans ,Radiology, Nuclear Medicine and imaging ,Endoscopy, Digestive System ,Prospective Studies ,Duodenal Diseases ,Prospective cohort study ,Aged ,medicine.diagnostic_test ,business.industry ,Gallbladder ,Pancreatic Ducts ,Gastroenterology ,Reflux ,Middle Aged ,medicine.disease ,Endoscopy ,medicine.anatomical_structure ,Amylases ,Balloon dilation ,Sphincter ,Female ,Bile Ducts ,Radiology ,business - Abstract
Background Endoscopic papillary balloon dilation reduces sphincter function at least transiently or partially, which may allow pancreatobiliary and duodenobiliary reflux to occur. This study prospectively evaluated pancreatobiliary and duodenobiliary reflux after endoscopic papillary balloon dilation. Methods In 12 patients with choledocholithiasis, ductal bile was sampled for amylase concentration and bacterial culture during ERCP, before and at 7 days to 5 years after endoscopic papillary balloon dilation. To provide comparative and control data, ductal bile was sampled in 12 patients with gallbladder cholesterol polyps and 6 with anomalous pancreaticobiliary junction who did not undergo endoscopic papillary balloon dilation. Results Amylase concentrations in ductal bile from patients with choledocholithiasis before endoscopic papillary balloon dilation were marginally significantly higher (before Bonferroni correction) compared with concentrations in bile from patients with gallbladder polyps. The concentration of amylase in bile was significantly increased at 7 days after endoscopic papillary balloon dilation compared with that before endoscopic papillary balloon dilation; the level was comparable with that of patients with an anomalous pancreaticobiliary junction. Subsequently, the amylase concentration gradually decreased and was approximately equal to the pre-endoscopic papillary balloon dilation level at 1 year. Bacteriocholia was frequent (67%–92%) for up to 3 months after endoscopic papillary balloon dilation but was rare thereafter. Conclusions Endoscopic papillary balloon dilation causes transient pancreatobiliary and duodenobiliary reflux. However, reflux is no longer present at 1 year after endoscopic papillary balloon dilation.
- Published
- 2004
35. Hepatoblastoma with cholangioblastic features (?cholangioblastic hepatoblastoma?) and other liver tumors with bimodal differentiation in young patients
- Author
-
Arthur Zimmermann
- Subjects
Hepatoblastoma ,Cancer Research ,Pathology ,medicine.medical_specialty ,Working Formulation ,Lineage (genetic) ,Adenoma ,Macrotrabecular Hepatoblastoma ,Adenoma, Bile Duct ,medicine ,Humans ,Progenitor cell ,business.industry ,Liver Neoplasms ,medicine.disease ,Phenotype ,digestive system diseases ,Bile Ducts, Intrahepatic ,Cell Transformation, Neoplastic ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Oncology ,Hepatocyte ,Pediatrics, Perinatology and Child Health ,business - Abstract
In a subset of hepatoblastomas, differentiation of neoplastic cells can proceed along a pathway resulting in cholangiocyte-like cells. These cells either occur as single, immunohistochemically detectable elements, or form incomplete and complete duct-like profiles in continuation with embryonal, fetal or macrotrabecular hepatoblastoma components. As a working formulation it is proposed to employ the term, hepatoblastoma with cholangioblastic features (or 'cholangioblastic' hepatoblastoma), to denote such lesions. This bimodal differentiation presents itself in other rare tumors in the form of complex arrays of duct-like cells encircling nests of neoplastic hepatocyte lineage cells, in some way mimicking a ductal plate. A possible pathogenetic pathway is suggested, i.e., uni- or bipotential neoplastic progenitors switch into either of the two lineages.
- Published
- 2002
36. Health of lake whitefish (Coregonus clupeaformis) with elevated tissue levels of environmental contaminants
- Author
-
Lucy L. J. Lee, John C. Harshbarger, Yves de Lafontaine, I. Mikaelian, and Daniel Martineau
- Subjects
Male ,Catostomus ,Coregonus clupeaformis ,Carcinoma, Hepatocellular ,Health Status ,Health, Toxicology and Mutagenesis ,Stizostedion ,Disorders of Sex Development ,Zoology ,Cholangiocarcinoma ,Adenoma, Bile Duct ,Animals ,Environmental Chemistry ,Gonads ,Salmonidae ,biology ,Ovotestis ,Ecology ,Liver Neoplasms ,Quebec ,biology.organism_classification ,Endocrine disruptor ,Ictalurus ,Toxicity ,Carcinogens ,Environmental Pollutants ,Female ,Environmental Monitoring - Abstract
Lake whitefish (Coregonus clupeaformis) were collected in 1996 from the St. Lawrence River, Quebec, Canada. Histologic examination was performed on major organs of 497 specimens and on the liver of 48 additional individuals. Preneoplastic and neoplastic hepatic changes consisted of vacuolated cell (n = 65), clear cell (n = 17), and acidophilic (n = 16) foci of altered hepatocyte, hepatocellular carcinoma (n = 12), cholangioma (n = 5), and cholangiocarcinoma (n = 28). Six fish were intersexes (1.2%), and 11.7% of the ovaries (26/223) had ducts containing spermatogonia or more differentiated cells of the male germ cell line. Asynchronous nodular maturation of the testes was present in 8.2% of the male fish (22/267). The mean hepatic concentrations of various contaminants, including polychlorinated biphenyls (PCBs), chlorobenzenes, pesticides, and trace metals, were 6 to 8 times higher in lake whitefish than in three other fish species (Ictalurus punctatus, Catostomus commersoni, and Stizostedion vitreum) collected at the same site. Condition factor of lake whitefish from this study was lower than that previously reported 40 to 50 years ago at this site and from contemporary pristine sites in the Great Lakes, USA. The presence of liver neoplasms, gonadal lesions, and a decreased condition factor in lake whitefish from the St. Lawrence River may be etiologically related to elevated tissue concentrations of toxic chemical contaminants.
- Published
- 2002
37. Bile duct adenoma and von Meyenburg complex-like duct arising in hepatitis and cirrhosis: pathogenesis and histological characteristics
- Author
-
Shinichi, Aishima, Yuki, Tanaka, Yuichiro, Kubo, Ken, Shirabe, Yoshihiko, Maehara, and Yoshinao, Oda
- Subjects
Liver Cirrhosis ,Male ,Adenoma, Bile Duct ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Hamartoma ,Humans ,Female ,Middle Aged ,Aged ,Hepatitis - Abstract
Morphologic features and neoplastic potentials of bile duct adenoma (BDA) and von Meyenburg complex (VMC)-like duct arising in chronic liver disease were unknown. Thirty-five BDAs and 12 VMC-like duct lesions were observed in 39 cases with chronic liver disease. BDAs were divided into the EMA-cytoplasmic type (n = 14) and EMA-luminal type (n = 21). EMA-cytoplasmic BDA composed of a proliferation of cuboidal to low-columnar cells forming an open lumen with NCAM(+)/MUC6(-), resembling an interlobular bile duct. EMA-luminal BDA showed uniform cuboidal cells with narrow lumen, and NCAM(++)/MUC6(++), resembling a ductular reaction. VMC-like duct showed positive MUC1 expression and negative MUC6. The expression of S100P, glucose transporter-1 (GLUT-1) and insulin-like growth factor II mRNA-binding protein 3 (IMP-3) were not detected in three lesions. p16 expression was higher than those of the ductular reaction, and the Ki67 and p53 indexes were very low (1.0%). Large-sized EMA-luminal BDA shows sclerotic stroma. We classified small nodular lesions of ductal or ductular cells in chronic hepatitis and cirrhosis into the following groups: BDA, interlobular bile duct type; BDA, ductular/peribiliary gland type; and VMC-like duct. They may be reactive proliferation rather than neoplastic lesions.
- Published
- 2014
38. Primary Liver Carcinoma in Genetic Hemochromatosis Reveals a Broad Histologic Spectrum
- Author
-
Claude Degott, Marie-Pierre Bralet, Jacques Belghiti, Sylvie Dubois, Mohib Morcos, and Benoit Terris
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Cirrhosis ,Biology ,Cholangiocarcinoma ,Immunoenzyme Techniques ,Cytokeratin ,Adenoma, Bile Duct ,Fibrosis ,Biomarkers, Tumor ,medicine ,Humans ,Hemochromatosis ,Bile Duct Adenoma ,Homozygote ,Liver Neoplasms ,Mucin-1 ,General Medicine ,Middle Aged ,medicine.disease ,digestive system diseases ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Hepatocellular carcinoma ,Mutation ,Keratins ,Immunohistochemistry ,Complication - Abstract
Hepatocellular carcinoma (HCC) is a well-known complication of genetic hemochromatosis (GH). However, the frequency of primary liver carcinoma (PLC) with biliary differentiation, such as cholangiocarcinoma (CC) and combined hepatocholangiocarcinoma (CHCC), in GH remains unclear. We analyzed the histologic type of 20 PLCs occurring in the background of GH; all patients were homozygotic for the C282Y mutation. Ten were depleted of iron by successive phlebotomies, while the remaining 10 were untreated. Histologically, 13 cases were classified as HCC, 3 as CC, and 4 as CHCC. Immunohistochemical detection of Hep Par 1, cytokeratin 19 (CK19), and MUC1 supported this classification; PLC with biliary differentiation was immunoreactive for MUC1 in 86% (6/7) of cases and for CK19 in 100% (7/7) of cases. The nontumoral liver exhibited no cirrhosis or extensive fibrosis in 6 cases. Von Meyenburg complexes were present in 11 cases and intraparenchymal bile duct adenomas in 3. These data suggest that PLCs in patients with GH present a wide histologic spectrum, with tumors showing frequent biliary differentiation; may arise on a nonfibrotic or a cirrhotic liver; and often are associated with Von Meyenburg complexes and to a lesser extent with bile duct adenomas.
- Published
- 2001
39. Atypical Bile Duct Adenoma, Clear Cell Type
- Author
-
Mai P. Hoang, Prasanna Sinkre, Jorge Albores-Saavedra, Linda A. Murakata, and Hadi Yaziji
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Adenoma ,Biology ,digestive system ,Pathology and Forensic Medicine ,Cholangiocarcinoma ,Adenoma, Bile Duct ,Carcinoembryonic antigen ,medicine ,Humans ,Nuclear atypia ,Bile Duct Adenoma ,Liver Neoplasms ,Middle Aged ,medicine.disease ,Immunohistochemistry ,digestive system diseases ,Biliary tract ,Clear Cell Hepatocellular Carcinoma ,biology.protein ,Adenocarcinoma ,Female ,Surgery ,Anatomy ,Clear cell - Abstract
A variable proportion of bile duct adenomas of the liver are still confused with metastatic well-differentiated adenocarcinoma by surgeons and pathologists. We present here three examples of previously undescribed primary hepatic bile duct tumors that were composed almost entirely of clear cells that closely mimicked metastatic renal cell carcinoma. They were interpreted as atypical bile duct adenomas and occurred in two males and one female whose ages ranged from 25 to 64 years. All three tumors were incidental findings and measured from 0.8 to 1.1 cm. The clear neoplastic cells showed mild nuclear atypia and no mitotic activity. They were arranged in tubules and nests that focally infiltrated the hepatic parenchyma. For comparison, a case of clear cell cholangiocarcinoma and 13 conventional bile duct adenomas were examined. The clear cell cholangiocarcinoma was larger (6.0 cm) and had the tubular pattern of conventional cholangiocarcinoma and an abundant desmoplastic stroma. The clear cells of this tumor exhibited greater nuclear atypia and increased mitotic activity. All three atypical bile duct adenomas expressed cytokeratin (CK) 7, p53 protein, epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA); they were negative for CK20, vimentin, Hep Par 1, chromogranin, and prostatic specific antigen (PSA) and exhibited less than 10% of Ki-67-positive nuclei. One atypical bile duct adenoma displayed luminal immunoreactivity for villin. With the exception of Ki-67 reactivity, the 13 conventional bile duct adenomas and the clear cell cholangiocarcinoma had essentially a similar immunohistochemical profile as that of the atypical clear cell bile duct adenomas. The absence of an extrahepatic primary tumor, the histologic features, the immunohistochemical profile, and the fact that all patients are symptom-free 2 months to 18 years after wedge liver biopsy support the interpretation of atypical clear cell bile duct adenoma. The differential diagnosis with clear cell hepatocellular carcinoma and metastatic clear cell carcinomas is discussed.
- Published
- 2001
40. Large Cystic Lesions of The Liver in Adults: A 15-Year Experience in A Tertiary Center
- Author
-
Unzila Ali, Joe U. Levi, Eugene R. Schiff, David Levi, K. Rajender Reddy, Mariana Berho, Alan S. Livingstone, Dan Sleeman, Enrique Molina, and Arie Regev
- Subjects
Adult ,Male ,Echinococcosis, Hepatic ,medicine.medical_specialty ,Cystadenoma ,Adenoma, Bile Duct ,Recurrence ,Open Resection ,Humans ,Medicine ,Cyst ,Cystadenocarcinoma ,Aged ,Retrospective Studies ,Aged, 80 and over ,Cysts ,business.industry ,Liver Diseases ,Middle Aged ,medicine.disease ,Echinococcosis ,Surgery ,Hypertonic saline ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Inhalation ,Biliary tract ,Female ,Hepatic Cyst ,business - Abstract
BACKGROUND: Cystic lesions of the liver consist of a heterogeneous group of disorders and may present a diagnostic and therapeutic challenge. Large hepatic cysts tend to be symptomatic and can cause complications more often than smaller ones. STUDY DESIGN: We performed a retrospective review of adults diagnosed with large (≥4cm) hepatic cystic lesions at our center, over a period of 15 years. Polycystic disease and abscesses were not included. RESULTS: Seventy-eight patients were identified. In 57 the lesions were simple cysts, in 8 echinococcal cysts, in 8 hepatobiliary cystadenomas, and in 1 hepatobiliary cystadenocarcinoma. In four patients, the precise diagnosis could not be ascertained. Mean size was 12.1cm (range, 4 to 30cm). Most simple cysts were found in women (F:M, 49:8). Bleeding into a cyst (two patients) and infection (one patient) were rare manifestations. Percutaneous aspiration of 28 simple cysts resulted in recurrence in 100% of the cases within 3 weeks to 9 months (mean 412 months). Forty-eight patients were treated surgically by wide unroofing or resection (laparoscopically in 18), which resulted in low recurrence rates (11% for laparoscopy and 13% for open unroofing). Four of the eight patients with echinococcal cysts were symptomatic. All were treated by open resection after irrigation of the cavity with hypertonic saline. There was no recurrence during a followup period of 2 to 14 years. Hepatobiliary cystadenomas occurred more commonly in women (F:M, 7:1) and in the left hepatic lobe (left:right, 8:0). Seven were multiloculated. All were treated by open resection, with no recurrence, and none had malignant changes. Cystadenocarcinoma was diagnosed in a 77-year-old man, and was treated by left hepatic lobectomy. CONCLUSIONS: Large symptomatic simple cysts invariably recur after percutaneous aspiration. Laparoscopic unroofing can be successfully undertaken, with a low recurrence rate. Open resection after irrigation with hypertonic saline is a safe and effective treatment for echinococcal cysts. Hepatobiliary cystadenomas have predilection for women and for the left hepatic lobe. Malignant transformation is an uncommon but real risk. Open resection is a safe and effective treatment for hepatobiliary cystadenoma, and is associated with a low recurrence rate.
- Published
- 2001
41. Papillary adenoma arising in the left hepatic duct: an unusual tumour in an uncommon location
- Author
-
Caroline S. Verbeke, Yoshiki Senda, Gareth Morris-Stiff, and Peter Lodge
- Subjects
Adenoma ,Mild Dysplasia ,Pathology ,medicine.medical_specialty ,Provisional diagnosis ,Gauche effect ,medicine.medical_treatment ,Papillary lesion ,Adenoma, Bile Duct ,Laparotomy ,Weight Loss ,medicine ,Humans ,Bile Duct Adenoma ,Aged ,Hepatology ,business.industry ,Gastroenterology ,Papillary Adenoma ,gamma-Glutamyltransferase ,Abdominal Pain ,Jaundice, Obstructive ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Female ,business ,Left Hepatic Duct - Abstract
Bile duct adenomas are rare tumours that arise more frequently in the distal extrahepatic biliary tree. We report the case of a papillary adenoma arising at the junction of the common and left hepatic ducts and review the available literature on this rare entity. A 73-year-old lady presented with a history of mild weight loss and vague upper abdominal pain. Routine blood tests revealed an elevated c-glutaryl transferase, and an ultrasound scan showed gross dilatation of the intrahepatic and extrahepatic biliary tree. Subsequent radiological imaging confirmed biliary dilatation and identified tumour within the left and common hepatic ducts with the provisional diagnosis of cholangiocarcinoma. At laparotomy, there was no evidence of extraductal tumour, and choledochoscopy showed a papillary lesion within the common hepatic and proximal left hepatic ducts. The tumour was excised and the biliary tree was reconstructed. Histological evaluation of the resected specimen confirmed a papillary adenoma with mild dysplasia. This case illustrates that not all biliary tumours are cholangiocarcinomas and referral to a hepatopancreaticobiliary unit for investigation and treatment is mandatory for all cases of obstructive jaundice.
- Published
- 2010
42. Clinical and radiological features of biliary papillomatosis
- Author
-
Hs Lam, Kf Ma, Lf Chau, Ak Ah Chong, and Pp Lu
- Subjects
Aged, 80 and over ,Cholangiopancreatography, Endoscopic Retrograde ,Male ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Biliary Papillomatosis ,Magnetic Resonance Imaging ,Epigastric pain ,Surgery ,Imaging modalities ,Adenoma, Bile Duct ,Bile Duct Neoplasms ,Radiological weapon ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Obstructive jaundice ,Tomography, X-Ray Computed ,business ,Serum alkaline phosphatase ,Aged ,Rare disease - Abstract
SUMMARY Biliary papillomatosis is a rare disease with strong potential for malignant degeneration. Diagnosis is often not easy and most are made intraoperatively. In the present study, five patients with biliary papillomatosis admitted between 1990 and 1997 were reviewed. Their clinical presentation, radiological and biochemical findings were analysed. The aim of the study was to discern a set of characteristic features that would enable an early diagnosis. All of the five patients presented with recurrent episodes of acute cholangitis and epigastric pain with raised serum alkaline phosphatase. Imaging modalities including ultrasound, CT, endoscopic retrograde cholangiopancreatogram, MRI and magnetic resonance cholangiopancreatogram were reviewed. Salient imaging features included a dilated biliary tree with multiple ill-defined and fuzzy filling defects or endoluminal frond-like mass lesions. In conclusion, biliary papillomatosis is a rare but important cause of biliary obstruction with relapsing cholangitis and obstructive jaundice. With a healthy index of suspicion, the diagnosis can be reached when the above features are available.
- Published
- 2000
43. Mucin-Hypersecreting Bile Duct Tumor Characterized by a Striking Homology with an Intraductal Papillary Mucinous Tumor (IPMT) of the Pancreas
- Author
-
Hyori Kim, M. H. Kim, B. C. Lim, Sung Koo Lee, Eun-Taek Park, Young-Il Min, Hyun-Ju Park, Kyo-Sang Yoo, Seung-Jae Myung, and Dong Wan Seo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Pathology ,Adenoma ,Biopsy ,medicine.medical_treatment ,Gastroenterology ,Cholangiocarcinoma ,Diagnosis, Differential ,Adenoma, Bile Duct ,Pancreatectomy ,Internal medicine ,medicine ,Hepatectomy ,Humans ,Aged ,Retrospective Studies ,Cholangiopancreatography, Endoscopic Retrograde ,Bile duct ,business.industry ,Mucins ,Ampulla of Vater ,Middle Aged ,medicine.disease ,Adenocarcinoma, Mucinous ,Pancreatic Neoplasms ,Bile Ducts, Intrahepatic ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Biliary tract ,Adenocarcinoma ,Female ,Mucinous Tumor ,Tomography, X-Ray Computed ,Pancreas ,business - Abstract
Background and study aims The mucin-hypersecreting bile duct tumor, which closely resembles an intraductal papillary mucinous tumor (IPMT) of the pancreas, is rare, and its clinical features are not well known. We report our experience of nine patients with this type of tumor, and analyze the data in order to elucidate its clinicopathologic characteristics. Patients and methods Between 1995 and 1998, nine consecutive patients (four men, five women; mean age 54) who were diagnosed as having a mucin-hypersecreting bile duct tumor were enrolled in this study. Results Recent or previous attacks of biliary pain and acute cholangitis were reported by most of the patients. Characteristics included a widely open ampulla of Vater with extrusion of mucin, and a diffuse dilated intrahepatic and extrahepatic bile duct with amorphous filling defects on cholangiogram. On cholangioscopic examination, a papillary mass or minute mucosal lesion was found in the dilated bile duct containing thick viscid mucin. Nine patients were referred for an operation, and curative resection was performed in eight of them. Using histologic examination, well differentiated adenocarcinoma in the background of benign hyperplasia and adenoma was documented in all patients except one, who showed pure adenoma. Conclusion The mucin-hypersecreting bile duct tumor can be characterized by a striking homology with IPMT of the pancreas in clinical, radiologic, and pathologic features.
- Published
- 2000
44. Papillary adenoma of the distal common bile duct
- Author
-
Mitsuhiro Inagaki, Yoshihiko Tokusashi, Shinichi Kasai, Isao Makino, Kazunori Yokoyama, Kazuhiko Onodera, Hidenori Ojima, Akira Ishizaki, Kakuya Matsumoto, Shuichi Kino, and Naoyuki Miyokawa
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Biopsy ,medicine.medical_treatment ,Common Bile Duct Neoplasms ,Gastroenterology ,Endosonography ,Pancreaticoduodenectomy ,Lesion ,Distal Common Bile Duct ,Adenoma, Bile Duct ,Internal medicine ,medicine ,Humans ,Pancreas ,Aged ,Cholangiopancreatography, Endoscopic Retrograde ,medicine.diagnostic_test ,Common bile duct ,business.industry ,Papillary Adenoma ,Hepatology ,Immunohistochemistry ,Ki-67 Antigen ,medicine.anatomical_structure ,Tumor Suppressor Protein p53 ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
A 73-year-old man with a papillary adenoma located in the distal common bile duct is reported. He underwent pylorus-preserving pancreatoduodenectomy. The lesion in the common bile duct featured papillary proliferation of the epithelium and fibrous elements with diffuse infiltration by inflammatory cells. Positive staining for MIB-1 (Ki-67) and p53 was identified in the nuclei of the proliferative epithelium. These findings suggested the malignant potential of this lesion. Further progress in imaging diagnostic techniques should increase the frequency with which such lesions are discovered. Even now, if mural irregularities and defects are found in the extrahepatic biliary system, especially the distal common bile duct, the possibility of such borderline biliary adenoma should be taken into consideration when making a diagnosis.
- Published
- 1999
45. Immunohistochemical localization of inducible nitric oxide synthase and 3-nitrotyrosine in rat liver tumors induced by N-nitrosodiethylamine
- Author
-
Dae Joong Kim, Byeongwoo Ahn, Beom Seok Han, and Hiroshi Ohshima
- Subjects
Male ,Cancer Research ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Nitric Oxide Synthase Type II ,Apoptosis ,Inflammation ,Biology ,Nitric oxide ,Rats, Sprague-Dawley ,chemistry.chemical_compound ,Adenoma, Bile Duct ,medicine ,Animals ,Diethylnitrosamine ,Cell damage ,Liver Neoplasms ,General Medicine ,HCCS ,medicine.disease ,Immunohistochemistry ,Rats, Inbred F344 ,Rats ,Nitric oxide synthase ,Liver ,chemistry ,biology.protein ,Tyrosine ,Tumor promotion ,Nitric Oxide Synthase ,medicine.symptom ,Precancerous Conditions ,Peroxynitrite - Abstract
Human liver cancers have been associated mainly with chronic inflammations such as viral hepatitis B or C. This suggests that prolonged cell damage by chronic inflammation is critical in cancer development. Overproduction of nitric oxide (NO-) and its derivative (NO x , peroxynitrite) has been implicated as a cause of tissue damage by inflammation, thus contributing to tumor promotion. We have demonstrated the expression of the inducible isoform of nitric oxide synthase (iNOS) and 3-nitrotyrosine, a marker of peroxynitrite formation, by immunohistochemistry in preneoplastic and neoplastic rat liver tissues induced by continuous infusion of N-nitrosodiethylamine with mini-pumps. The preneoplastic lesions were characterized by proliferation of phenotypically altered hepatic foci (PAHF), dysplastic hepatocytes and oval cells. Histologically, the tumors were hepatocellular carcinomas (HCCs) of trabecular, (pseudo)glandular and solid types with or without cholangiocellular involvement, iNOS was located mainly in oval cells, capillary endothelial and muscular cells, epithelia of cholangiomas and glandular HCCs. 3-Nitrotyrosine was observed in the cytoplasms of PAHF and dysplastic hepatocytes in preneoplasias and in the cytoplasms of some living or apoptotic HCC cells, connective tissues, proteinaceous fluids, sinusoidal endothelia of tumorous hepatocytes and cholangiomas in tumors. From these observations, we suggest that: (i) chronic tissue damage by chemical carcinogens may act to induce iNOS and peroxynitrite formation; (ii) oval cells play a key role in development and/or growth of tumor tissues by producing NO- via iNOS, which may also cause tissue damage by peroxynitrite; (iii) iNOS can be considered as a phenotypic marker in cells of oval cell lineage and neovascularized capillaries in tumor tissues.
- Published
- 1999
46. Ciliated Hepatic Foregut Cyst
- Author
-
Michael T. Deavers, Joyce Cain, Kamal G. Ishak, Zachary Goodman, and Dan J. Vick
- Subjects
Male ,Echinococcosis, Hepatic ,Pathology ,medicine.medical_specialty ,Adolescent ,Adenoma ,Cystadenoma ,Biology ,Epithelium ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Lesion ,Adenoma, Bile Duct ,Bile Ducts, Extrahepatic ,Biomarkers, Tumor ,medicine ,Humans ,Cyst ,Cilia ,Foregut Cyst ,Cysts ,Liver Diseases ,Foregut ,Anatomy ,Middle Aged ,medicine.disease ,Echinococcosis ,medicine.anatomical_structure ,Bile Duct Neoplasms ,Female ,Surgery ,Pseudostratified columnar epithelium ,Differential diagnosis ,medicine.symptom - Abstract
Ciliated hepatic foregut cyst (CHFC) is a rare, benign, solitary cyst consisting of ciliated pseudostratified columnar epithelium, subepithelial connective tissue, a smooth muscle layer, and an outer fibrous capsule. We studied six previously unreported cases of CHFC and 50 cases from the literature. The literature search revealed that Friedreich first described the lesion in 1857 and hypothesized its congenital origin. The cyst generally is found incidentally on radiologic imaging or during surgical exploration, although one case presented with portal vein compression. It occurs more frequently in men and is found most commonly in the medial segment of the left hepatic lobe, unlike most other solitary cysts that show a female predominance and greater occurrence in the right hepatic lobe. Two of the 56 cases were multilocular. There has been an increase in the number of reports of CHFC during the past 15 years. This may reflect the increased availability and use of various radiologic imaging modalities. A large number of cases have been reported in the Japanese population, but the significance of this is unclear. CHFC should be considered in the differential diagnosis of other solitary liver cysts, including simple cysts, hepatobiliary cystadenomas, and parasitic cysts.
- Published
- 1999
47. ULTRASONOGRAPHIC EVALUATION OF BILIARY CYSTADENOMAS IN CATS
- Author
-
Thomas G. Nyland, Philip D. Koblik, and Sharon E. Tellyer
- Subjects
Male ,medicine.medical_specialty ,Pathology ,Liver tumor ,Cystadenoma ,Cat Diseases ,Adenoma, Bile Duct ,Animals ,Medicine ,Ultrasonography ,CATS ,General Veterinary ,medicine.diagnostic_test ,business.industry ,Echogenicity ,medicine.disease ,Abdominal mass ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Abdominal ultrasonography ,Cats ,Female ,Hepatic Cyst ,Radiology ,medicine.symptom ,Differential diagnosis ,business - Abstract
The purpose of this study was to describe the ultrasonographic appearance of biliary cystadenomas in cats and compare the findings to a similar rare form of liver tumor in humans. Biliary cystadenomas are uncommon, benign liver tumors of older cats that may occur as focal or multifocal cystic lesions within the liver. The records of 10 cats which had abdominal ultrasonography and histologic diagnosis of biliary cystadenoma were reviewed. The average age of affected cats was 13.3 years (range 10-16 years). Eight cats were neutered males and two were neutered females. In three cats, the tumors were not seen ultrasonographically due to their small size or from being obscured by near-field reverberation echoes. The remaining seven cats had solitary (4 cats) or multifocal (3 cats) masses corresponding to variable ultrasonographic patterns: multilocular masses containing thin-walled cysts, hyperechoic masses with cystic components, or masses of mixed echogenicity with cystic components. The masses had variable ultrasonographic patterns when multifocal disease was present. Recognizable cysts were evident somewhere within the tumors seen ultrasonographically, although sometimes the cysts appeared very small. The biliary cystadenomas were thought to be clinically silent. Although liver enlargement or a cranial abdominal mass was palpable in 4 cats, no consistent trend of clinical signs, CBC or serum biochemical abnormalities could be directly attributed to biliary cystadenoma. The treatment of choice is surgical resection of the tumor, as continued growth may compress adjacent vital structures within the liver. The differential diagnosis of biliary cystadenomas from other cystic liver lesions such as hepatic cysts, hematomas, abscesses, parasitic cysts, or other liver tumors is discussed.
- Published
- 1999
48. Biliary cystadenoma of the liver with elevated CA 19-9
- Author
-
Jacques Rahier, Jean-François Gigot, Yves Horsmans, D. Schoonbroodt, and André Geubel
- Subjects
medicine.medical_specialty ,Pathology ,CA-19-9 Antigen ,Hepatology ,business.industry ,Cystadenoma ,Enucleation ,Intrahepatic bile ducts ,medicine.disease ,Gastroenterology ,Elevated serum ,Adenoma, Bile Duct ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Antigen ,Internal medicine ,medicine ,Humans ,Female ,CA19-9 ,business ,Aged ,Biliary cystadenoma ,Mesenchymal stroma - Abstract
A case of intrahepatic biliary cystadenoma with mesenchymal stroma is reported. The tumor was associated with strikingly elevated serum and intracystic levels of the tumor-associated antigen CA19-9. Two months after surgical enucleation, serum CA 19-9 levels returned to normal.
- Published
- 2008
49. A COMPARISON BETWEEN PRIMARY AND SECONDARY LIVER CANCER
- Author
-
J. M. Little
- Subjects
Male ,Oncology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Liver secondaries ,Hepatic resection ,Gastroenterology ,Adenoma, Bile Duct ,Actuarial Analysis ,Internal medicine ,Ethnicity ,medicine ,Humans ,Survival advantage ,Aged ,business.industry ,Liver Neoplasms ,Palliative Care ,Treatment method ,Middle Aged ,Secondary liver cancer ,Prognosis ,Biological significance ,Female ,Surgery ,business ,Primary liver cancer - Abstract
Two groups of patients have been compared, one with primary liver cancer, the other with liver secondaries. The groups did not demonstrate major differences in age, sex, ethnic background or treatment methods. Although patients with secondaries showed some survival advantage during the first 6-12 months, any difference had disappeared by 24 months. Patients with potentially 'curable' lesions having hepatic resection fared significantly better than all other patients, whether their tumours were primary or secondary in the liver. For practical purposes, the two groups can be considered as having problems of comparable biological significance.
- Published
- 2008
50. Biliary cystadenoma of the liver
- Author
-
Jin Sub Choi, Young Nyun Park, Kyung Sik Kim, Byong Ro Kim, and Woo-Jung Lee
- Subjects
Adult ,medicine.medical_specialty ,Adenoma ,Cystadenoma ,Lesion ,Adenoma, Bile Duct ,Surgical oncology ,Internal medicine ,medicine ,Humans ,Cyst ,Cystadenocarcinoma ,Hepatology ,business.industry ,medicine.disease ,Surgery ,Bile Ducts, Intrahepatic ,Bile Duct Neoplasms ,Female ,Radiology ,medicine.symptom ,business ,Abdominal surgery - Abstract
Hepatobiliary cystadenoma is an uncommon lesion that is difficult to diagnose preoperatively. Here we report a 34-year-old woman who presented with enlargement of a cyst that had been observed for the previous 6 months. Diagnostic imaging revealed a 7-cm diameter cystic mass with irregular multiple septation in her liver. All laboratory test results were normal except for serum carbohydrate antigen (CA) 19-9 (62.5 U/ml). Because of the malignant potential and the history of enlargement, a complete surgical excision was performed. The patient was discharged after a good recovery; 2 months after surgery her serum CA19-9 level had returned to normal (32.9 U/ml). Regardless of the diagnostic modalities used, cystadenoma and cystadenocarcinoma cannot be differentiated with accuracy. Therefore complete surgical resection is the recommended therapy.
- Published
- 1998
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.