40 patients diagnosed as cholangiome of which 9 patients diagnosed by biliary cell, 13 patients diagnosed by CT scanner, and 18 patients diagnosed by operation. The biliary obstruction in the general hepatic tube occurred in 95% of patients in which the lesion involved in the 2 branches of liver was 75%. The image of cholangiome in the film of cholangiography found that biliary fair stenosid (62,5%).
Adenoma, Bile Duct ; diagnosis

Villous adenomas of the common bile duct are rare and accordingly it is difficult to render a firm preoperative diagnosis. They are the unusual cause of bile duct obstruction and can mimic malignant extrahepatic biliary tumors or stones. Until recently, only a few cases had been reported in the medical literature. Although some authors advocate open surgical excision, especially with recurrence or carcinomatous change, an endoscopic resection of a distal common bile duct adenoma is a viable alternative for those patients considered poor surgical risks. We present two cases of villous adenoma of the common bile duct diagnosed by an endoscopic biopsy and endoscopically resected, with review of the relevant literature on the subject.
Adenoma ; Adenoma, Villous* ; Biopsy ; Cholestasis ; Common Bile Duct* ; Diagnosis* ; Humans ; Recurrence

BACKGROUND/AIMS: The technique of cholangioscopy has been used in the treatment of bile duct stones or for the diagnosis of various bile duct tumors. However, the cholangioscopic characteristics of the various types of bile duct tumors have not yet been clearly described. Therefore, we analyzed the results of our cholangioscopic examinations and classified the cholangioscopic findings according to tumor histology. METHODS: The cholangioscopic finding from 111 patients who had benign or malignant bile duct tumors were reviewed. The mucosal changes, the presence of neovascularization, and the patterns of luminal narrowing were analyzed and compared with the histologic diagnosis. RESULTS: Bile duct adenocarcinoma can be classified into three different types according to the cholangioscopic findings: nodular, papillary, and infiltrative. Bile duct adenoma, hepatocellular carcinoma and other types of bile duct cancer such as mucin-hypersecreting cholangiocarcinoma, biliary cystadenocarcinoma, squamous cell carcinoma also presented with their unique cholangioscopic characteristics. CONCLUSIONS: Bile duct tumors seem to show characteristic cholangioscopic findings according to their histology. Cholangioscopic examination seems to be a useful technique in the differential diagnosis of bile duct tumors.
Adenocarcinoma ; Adenoma, Bile Duct ; Bile Duct Neoplasms ; Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular ; Carcinoma, Squamous Cell ; Cholangiocarcinoma ; Cystadenocarcinoma ; Diagnosis ; Diagnosis, Differential ; Humans ; Phenobarbital

Villous adenomas are benign epithelial lesions with malignant potential which can occur at any site in the gastrointestinal tract. They are usually encountered in the rectum and colon, less frequently in the small bowel and very rarely in the biliary trees. Nine cases of bile duct villous adenomas have been reported in the literature. However, 4 cases of bile duct villous adenomas have been reported in the Korean literature. Recently, we experienced a case of villous adenoma in the common hepatic duct in a 77-year-old man presenting with obstructive jaundice in which preoperative histologic diagnosis of villous adenoma played a critical role in managing this patient. Herein, we present a case report of bile duct villous adenoma and a review of the reported cases in Korea to help define and manage this rare disease entity in the bile ducts. In addition, confusing nomenclature of bile duct adenomas is discussed.
Adenoma, Villous/therapy* ; Adenoma, Villous/diagnosis ; Aged ; Bile Duct Neoplasms/therapy* ; Bile Duct Neoplasms/diagnosis ; Case Report ; Cholestasis/etiology ; Human ; Male

No abstract available.
Adenoma, Bile Duct/*diagnosis ; Bile Duct Neoplasms/*diagnosis ; *Bile Ducts, Intrahepatic ; Diffusion Magnetic Resonance Imaging/*methods ; Humans ; Liver Cirrhosis/*complications ; Male

A 64-year-old male patient with liver cirrhosis underwent a CT study for hepatocellular carcinoma surveillance, which demonstrated a 1.4-cm hypervascular subcapsular tumor in the liver. On gadoxetic acid-enhanced MRI, the tumor showed brisk arterial enhancement and persistent hyperenhancement in the portal phase, but hypointensity in the hepatobiliary phase. On diffusion-weighted MRI, the tumor showed an apparent diffusion coefficient twofold greater than that of the background liver parenchyma, which suggested that the lesion was benign. The histologic diagnosis was intrahepatic bile duct adenoma with alcoholic liver cirrhosis.
Adenoma, Bile Duct/*diagnosis/etiology ; Bile Duct Neoplasms/*diagnosis/etiology ; *Bile Ducts, Intrahepatic ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Diffusion Magnetic Resonance Imaging/*methods ; Gadolinium DTPA/diagnostic use ; Humans ; Liver Cirrhosis/*complications/diagnosis ; Male ; Middle Aged

BACKGROUND/AIM: Endoscopic screening for the detection of premalignant high-grade dysplasia remains time consuming and is subject to sampling error. We performed this study to determine the clinical usefulness of laser endoscopic spectra analyzer (LESA-7) in gastrointestinal cancer and dysplastic lesions. METHODS: Seventeen patients with histologically proven carcinoma or adenoma with or without high-grade dysplasia were treated with oral administration of 5-ALA (20 mg/kg). PDD was performed 4 hours later. The fluorescence was excited by a helium-neon laser with emission at 637 nm. The generated fluorescence light was collected and fed into a multi-channel analyzer and the full spectrum was displayed in real time (LESA-7). RESULTS: In most of malignant tumors, a clear protoporphyrin IX-related dual-peaked fluorescence signal at about 635 and 700 nm was identified in the fluorescence spectra. However, it was not fully identified in bile duct cancers. In PDD of post-EMR in order to detect residual lesions (gastric flat adenoma 1, early gastric cancer 2), a dual spectra was not identified. CONCLUSIONS: PDD with 5-ALA might be useful for the detection of dysplasia and carcinoma in the gastrointestinal tract.
Adenoma ; Administration, Oral ; Bile Duct Neoplasms ; Diagnosis* ; Fluorescence ; Gastrointestinal Neoplasms* ; Gastrointestinal Tract ; Humans ; Mass Screening ; Selection Bias ; Stomach Neoplasms

The diagnosis of hepatocellular carcinoma (HCC) is based on imaging studies particularly in high-risk patients without histologic confirmation. This study evaluated the prevalence and characteristics of false-positively diagnosed HCC in a liver resection cohort for HCC. A retrospective review was performed of 837 liver resection cases for clinically diagnosed HCC between 2005 and 2010 at our institute. High-risk patients with tumors > 1 cm with one or two image findings consistent with HCC and tumors < 1 cm with two or more image findings consistent with HCC with persistently increased serum alpha-fetoprotein (AFP) levels above the normal range with underlying inhibited hepatitis activity underwent liver resection. The false-positive rate was 2.2% (n = 18). Of the 18 patients, 7 patients (0.8%) were diagnosed with benign conditions (one each of hemangioma, inflammation, cortical adenoma, dysplastic nodule, angiomyolipoma, bile duct adenoma, and non-neoplastic liver parenchyme) and 11 patients (1.3%) were diagnosed with malignancies (cholangiocarcinoma [n = 6], hepatoblastoma [n = 2], and one each of lymphoepithelioma-like carcinoma, ovarian cystadenocarcinoma, and nasopharynx carcinoma metastasis). The clinical characteristics of pathologically diagnosed HCC patients were similar (P > 0.05) compared to non-HCC patients except for higher rate of history of alcoholism (P < 0.05) observed in non-HCC patients. Four of 18 non-HCC patients (22.2%) showed diagnostic discordance on the dynamic imaging study. Despite the recent progression in diagnostic imaging techniques, 2.2% of cases were false-positively diagnosed as HCC in a liver resection patient cohort; and the final diagnosis was benign disease in 0.8% of liver resection patients clinically diagnosed with HCC.
Adenoma ; Adenoma, Bile Duct ; Alcoholism ; alpha-Fetoproteins ; Angiomyolipoma ; Carcinoma, Hepatocellular* ; Cohort Studies ; Cystadenocarcinoma ; Diagnosis* ; Diagnostic Imaging ; Hemangioma ; Hepatitis ; Hepatoblastoma ; Humans ; Inflammation ; Liver* ; Nasopharynx ; Prevalence ; Reference Values ; Retrospective Studies

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.
Adenoma, Bile Duct/*diagnosis/surgery ; Bile Duct Neoplasms/*diagnosis/surgery ; Contrast Media/diagnostic use ; Female ; Hamartoma/*diagnosis/surgery ; Hepatectomy ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Tomography, X-Ray Computed

Choledochal cyst is an uncommon premalignant anomaly. The morphology and pathogenesis of the premalignant lesion of cholangiocarcinoma arising from the choledochal cyst has not been well described. Herein, we report a rare case of bile duct adenoma arising from choledochal cyst with anomalous union of pancreaticobiliary duct (AUPBD). 50-year-old woman was admitted to our hospital with the complaint of epigastric pain. She had received common bile duct (CBD) exploration and choledocholithotomy and cholecystectomy 3 months earlier under the diagnosis of multiple CBD stones. Intraoperalive cholangiogram was not remarkable except CBD dilatation at that time. Endoscopic retrograde cholangiopancreatography revealed choledochal cyst with AUPBD and round filling defect which disappeared easily on the balloon cholaniogram. On magnetic resonance cholangiopancreatography, the filling defect was confirmed as 2 cm polypoid mass attached to the distal bile duct wall. At laparotomy, a soft whitish mass was palpable on the lower CBD. On histological examination, adenoma with focal carcinoma change arising from choledochal cyst was diagnosed.
Adenoma, Villous/*diagnosis/pathology/radiography ; Bile Duct Neoplasms/*diagnosis/pathology/radiography ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst/*radiography/secretion/surgery ; Female ; Humans ; Middle Aged ; Tomography, X-Ray Computed