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.
Hirayama
Yutaka
Y
Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan. you4141@aol.com
Kubota
Masayuki
M
Hasegawa
Go
G
Okuyama
Naoki
N
Ohtaki
Masahiro
M
Kobayashi
Kumiko
K
Tsukada
Mami
M
Sato
Kanako
K
Nishikura
Ken
K
Naito
Makoto
M
Ajioka
Yoichi
Y
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