A case of a choledochal cyst associated with a lymphatic infiltration of a hyperplastic gallbladder epithelium.
A 4-year-old girl with a congenital choledochal cyst (Todani IV-A, Komi type A) underwent a resection of the dilated common bile duct and gallbladder. Histologic studies of the gallbladder showed a general hyperplastic change associated with cribriform proliferation at the gland base of the gallbladder. In this region, clusters of cribriform glands were found within the lymphatic vessels, compatible with lymphatic infiltration of tumor cells. However, careful histologic studies did not reveal any apparent neoplastic changes in the gallbladder and common bile duct, so a final diagnosis of epithelial atypism with reactive hypertrophy was made. The displacements observed in the lymphatics are just an incidental finding in a proliferative process of the hyperplastic gallbladder epithelium. In the follow-up observation for 3 years, the patient is doing well without evidence of tumor recurrence. These results suggest that a mere lymphatic infiltration of hyperplastic gallbladder epithelium should not be directly considered as evidence of carcinogenesis.
Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan. you4141@aol.com
Yutaka
Y
Hirayama
Masayuki
M
Kubota
Go
G
Hasegawa
Naoki
N
Okuyama
Masahiro
M
Ohtaki
Kumiko
K
Kobayashi
Mami
M
Tsukada
Kanako
K
Sato
Ken
K
Nishikura
Makoto
M
Naito
Yoichi
Y
Ajioka
D002675:Child, Preschool; D002763:Cholecystectomy / Q000379:methods; D015529:Choledochal Cyst / Q000175:diagnosis* / Q000601:surgery; D003135:Common Bile Duct / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D004848:Epithelium / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000473:pathology* / Q000601:surgery; D005706:Gallbladder Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D007150:Immunohistochemistry; D033162:Incidental Findings; D042601:Lymphatic Vessels / Q000473:pathology* / Q000503:physiopathology; D018570:Risk Assessment; D016896:Treatment Outcome