Intrahepatic bile duct adenoma in a patient with chronic hepatitis B accompanied by elevation of alpha-fetoprotein.
10.3350/cmh.2015.21.4.393
- Author:
Jem Ma AHN
1
;
Yong Han PAIK
;
Jun Hee LEE
;
Ju Yeon CHO
;
Won SOHN
;
Geum Youn GWAK
;
Moon Seok CHOI
;
Joon Hyeok LEE
;
Kwang Cheol KOH
;
Seung Woon PAIK
;
Byung Chul YOO
Author Information
1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yh.paik@samsung.com
- Publication Type:Case Reports
- Keywords:
Adenoma;
Bile duct;
Hepatitis B;
Alpha-fetoproteins;
Ultrasonography
- MeSH:
Bile Duct Neoplasms/*complications/*diagnosis/pathology;
*Bile Ducts, Intrahepatic;
Hepatitis B, Chronic/*complications/*diagnosis/pathology;
Humans;
Liver/pathology/ultrasonography;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Tomography, X-Ray Computed;
alpha-Fetoproteins/*metabolism
- From:Clinical and Molecular Hepatology
2015;21(4):393-397
- CountryRepublic of Korea
- Language:English
-
Abstract:
A 51-year-old male patient with chronic hepatitis B was referred to our hospital due to a 1-cm liver nodule on ultrasonography. Alpha-fetoprotein (AFP) was slightly elevated. The nodule showed prolonged enhancement on dynamic liver magnetic resonance imaging and appeared as a hyperintensity on both diffusion-weighted and T2-weighted imaging. The nodule was followed up because it was small and typical findings of hepatocellular carcinoma (HCC) were not observed in the dynamic imaging investigations. However, liver contrast-enhanced ultrasonography performed 1 month later showed enhancement during the arterial phase and definite washout during the delayed phase. Also, AFP had increased to over 200 ng/mL even though AST and ALT were decreased after administering an antiviral agent. He was presumptively diagnosed as HCC and underwent liver segmentectomy. Microscopy findings of the specimen indicated bile duct adenoma. After resection, the follow-up AFP had decreased to within the normal range. This patient represents a case of bile duct adenoma with AFP elevation mimicking HCC on contrast-enhanced ultrasonography.
