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Difference between revisions of "Bile duct adenoma"
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==General== | ==General== | ||
*Benign. | *Benign. | ||
*Important as it can be misdiagnosed as cancer. | *Important as it can be misdiagnosed as [[cancer]]. | ||
==Microscopic== | ==Microscopic== | ||
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*Disordered bile ducts within in a fibrotic stroma. | *Disordered bile ducts within in a fibrotic stroma. | ||
**'''No''' (yellow) bile within, as these lesions do not have a connection to the biliary tree. | **'''No''' (yellow) bile within, as these lesions do not have a connection to the biliary tree. | ||
**+/-Lymphocytic cuff. | **+/-Lymphocytic cuff.<ref>URL: [http://www.surgpath4u.com/caseviewer.php?case_no=152 http://www.surgpath4u.com/caseviewer.php?case_no=152]. Accessed on: 6 March 2014.</ref> | ||
Negatives: | Negatives: | ||
| Line 20: | Line 20: | ||
*[[Cholangiocarcinoma]]. | *[[Cholangiocarcinoma]]. | ||
*Metastatic adenocarcinoma. | *Metastatic adenocarcinoma. | ||
**[[Pancreatic ductal adenocarcinoma]].<ref name=pmid15725808>{{Cite journal | last1 = Hornick | first1 = JL. | last2 = Lauwers | first2 = GY. | last3 = Odze | first3 = RD. | title = Immunohistochemistry can help distinguish metastatic pancreatic adenocarcinomas from bile duct adenomas and hamartomas of the liver. | journal = Am J Surg Pathol | volume = 29 | issue = 3 | pages = 381-9 | month = Mar | year = 2005 | doi = | PMID = 15725808 }}</ref> | |||
*[[Bile duct hamartoma]] (von Meyenburg complex). | *[[Bile duct hamartoma]] (von Meyenburg complex). | ||
===Images=== | ===Images=== | ||
*[http://www.ganfyd.org/index.php?title=Image:Bile_duct_adenoma_low_power.jpg Bile duct adenoma (ganfyd.org)]. | *[http://www.ganfyd.org/index.php?title=Image:Bile_duct_adenoma_low_power.jpg Bile duct adenoma (ganfyd.org)]. | ||
*[http://www.surgpath4u.com/caseviewer.php?case_no=152 Bile duct adenoma (surgpath4u.com)]. | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3926226/figure/fig1/ Bile duct adenoma - oncocytic - low mag. (nih.gov)].<ref name=pmid24592348/> | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3926226/figure/fig2/ Bile duct adenoma - oncocytic - high mag. (nih.gov)].<ref name=pmid24592348/> | |||
[[File:5 2033397936391 sl 1.png|Bile duct adenoma]] | |||
[[File:5 2033397936391 sl 2.png|Bile duct adenoma]] | |||
[[File:5 2033397936391 sl 3.png|Bile duct adenoma]] | |||
[[File:5 2033397936391 sl 4.png|Bile duct adenoma]] | |||
[[File:5 2033397936391 sl 5.png|Bile duct adenoma]]<br> | |||
Bile duct adenoma in a 67 yo man, not radiologically detected; this is important because cholangiocarcinomas are larger than bile duct adenomas. Bile duct adenomas are usually incidental findings, as in this case. These can be very difficult diagnosis; this case was evaluated by outside consultation. A. Glandular proliferation is seen. Note the curve indicated by the arrow, indicating a subcapsular location. B. The central scar, in other locations and with metastases, a finding associated with carcinoma, is in the liver a benign sign. The intense hyalin is also a benign sign, being that of a well-developed adenoma. C. Nuclear atypia in this case is modest near the region of scar, with tortuous glands. D. As the lesion progresses away from the scar, the atypia diminishes. Mitoses and outright necrosis were not identified. E. PAS-D stain shows the red rims about the glands, a benign sign, but also red cytoplasmic droplets, which is consistent with bile duct adenoma’s being known to produce mucin. | |||
==IHC== | ==IHC== | ||
*CK7 +ve. | *CK7 +ve. | ||
*HepPar-1 -ve. | *HepPar-1 -ve. | ||
* | *Ki-67 low. | ||
Others:<ref name=pmid15725808/> | |||
*p53 -ve. | |||
*mCEA -ve. | |||
==See also== | ==See also== | ||