title: Intrahepatic biliary papilloma morphologically similar to biliary cystadenoma.
abstract: A 37-year-old man presented complaining of epigastralgia. Abdominal ultrasonography revealed the presence of a papillary tumor (9 mm in diameter) in the cystic lesion (18 mm in diameter) in hepatic segment 4, which was accompanied by mild intrahepatic bile duct dilatation. Although abdominal computed tomography also showed the cystic lesion, it did not show papillary tumors inside the lesion. Endoscopic retrograde cholangiography showed the communication between the cystic lesion and the left hepatic duct. In addition, mucus was observed in the common bile duct. When transpapillary intraductal ultrasonography was performed through the left hepatic duct using a fine ultrasonic probe, a hyperechoic papillary and lobulated tumor was clearly shown in the cystic lesion. The wall of the cyst was smooth and there was no sign of tumor infiltration. Based on these findings, biliary cystadenoma was diagnosed and an extended left lobectomy was carried out. However, pathological findings postoperatively revealed that the lesion was a localized biliary papilloma, developing and extending to the intrahepatic duct. This case is rare and there have been no published reports describing a biliary papilloma morphologically similar to biliary cystadenoma.
authors.affiliation: Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan. saoki@med.nagoya-u.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Aoki
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Okayama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kitajima
authors.forename: Kazuki
authors.initials: K
authors.lastname: Hayashi
authors.forename: Hideto
authors.initials: H
authors.lastname: Imai
authors.forename: Tetsu
authors.initials: T
authors.lastname: Okamoto
authors.forename: Shinji
authors.initials: S
authors.lastname: Akita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Gotoh
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ohara
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nomura
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Itoh
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003537:Cystadenoma / Q000000981:diagnostic imaging / Q000473:pathology; D006498:Hepatectomy; D006801:Humans; D008297:Male; D010212:Papilloma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014463:Ultrasonography