胆管腺瘤临床病理特点

Analysis of clinicopathological features of bile duct adenoma of the liver

目的:探讨胆管腺瘤(bile duct adenoma,BDA)的临床病理特点、诊断及鉴别诊断.方法:报道2例肝脏BDA并结合文献分析其临床资料、形态学和免疫表型特征.结果:2例结节样肝脏肿块均在CT扫描被无意中发现,患者无临床症状.肉眼见肿块呈灰白色,质硬,其边界完整但无包膜.组织学显示肿瘤由或圆或不规则的腺管状结构及丰富的纤维性间质构成.这些腺样结构扩张不明显,内衬柱状或立方上皮,细胞核圆而规则,缺乏异型性.免疫组织化学显示CK(pan)、CK7及E-cadherin表达阳性.结论:胆管腺瘤是一种罕见的独具临床病理特点的良性肝脏肿瘤,应与高分化胆管细胞癌及Von Meyenberg综合征等相鉴别.

AIM： To analyze the clinicopathological charac- teristics, diagnosis and differential diagnosis of bile duct adenoma （BDA） of the liver. METHODS： Two cases of BDA of the liver were reported. Their clinical data, pathologic features, and immunophenotypes were analyzed. A re- view of related literature was also performed. RESULTS： Asymptomatic nodular masses of the liver were revealed incidentally during a CT scan in both cases. Grossly, the masses were de- scribed as firm white lesions with well-defined margins, but were not encapsulated. Histologi- cally, the tumors were composed of round duc- tal or irregular glandular structures and abun- dant fibrous stroma. Those adenoid components showed no obvious dilatation and were lined by columnar or cuboidal cells that have regular nuclei and lack dysplasia. Immunohistochemi- cally, the tumor cells were positive for epithelial markers such as CK （pan）, CK7 and E-cadherin. CONCLUSION： BDA of the liver is a rare benigh tumor with unique clinicopathological features. It should be distinguished from some mimics such as well-differentiated intrahepatic cholangiocarci- noma （ICC） and Von Meyenburg＇s complex.