Biliary cystadenoma and cystadenocarcinoma: clinical-imaging-pathologic correlations with emphasis on the importance of ovarian stroma.
OBJECTIVE
To evaluate cross-sectional imaging in the distinction of biliary cystadenoma from cystadenocarcinoma and in the determination of the presence of ovarian stroma.


METHODS
In 34 patients, radiologic studies and specimen photographs and descriptions were reviewed retrospectively without knowledge of the patient group. Histologic features were reviewed without knowledge of the radiologic findings and analyzed for epithelial and stromal components. Correlation was made between the radiologic findings, gross morphologic features, internal fluid characteristics, and histologic features.


RESULTS
The 34 patients had 27 biliary cystadenomas, 22 with ovarian stroma, and seven cystadenocarcinomas, four with ovarian stroma. Gross morphologic and imaging features suggestive of biliary cystadenocarcinoma included internal septation and nodularity. Septation without nodularity was seen only in biliary cystadenoma. Nonbilious fluid was the only feature associated with the presence of ovarian stroma but was not distinguishable on images.


CONCLUSIONS
Imaging studies accurately reflect the nodularity and septation seen grossly to distinguish biliary cystadenoma and cystadenocarcinoma but do not allow distinction of the presence or absence of ovarian stroma.
Buetow
P C
PC
Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Buck
J L
JL
Pantongrag-Brown
L
L
Ros
P R
PR
Devaney
K
K
Goodman
Z D
ZD
Cruess
D F
DF
D002759:Adenoma, Bile Duct / Q000175:diagnosis* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000473:pathology; D003536:Cystadenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D003537:Cystadenoma / Q000175:diagnosis* / Q000473:pathology; D003952:Diagnostic Imaging; D004848:Epithelium / Q000473:pathology; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010053:Ovary / Q000473:pathology*; D012189:Retrospective Studies; D017154:Stromal Cells / Q000473:pathology*