title: Bile duct adenoma and von Meyenburg complex-like duct arising in hepatitis and cirrhosis: pathogenesis and histological characteristics.
abstract: Morphologic features and neoplastic potentials of bile duct adenoma (BDA) and von Meyenburg complex (VMC)-like duct arising in chronic liver disease were unknown. Thirty-five BDAs and 12 VMC-like duct lesions were observed in 39 cases with chronic liver disease. BDAs were divided into the EMA-cytoplasmic type (n = 14) and EMA-luminal type (n = 21). EMA-cytoplasmic BDA composed of a proliferation of cuboidal to low-columnar cells forming an open lumen with NCAM(+)/MUC6(-), resembling an interlobular bile duct. EMA-luminal BDA showed uniform cuboidal cells with narrow lumen, and NCAM(++)/MUC6(++), resembling a ductular reaction. VMC-like duct showed positive MUC1 expression and negative MUC6. The expression of S100P, glucose transporter-1 (GLUT-1) and insulin-like growth factor II mRNA-binding protein 3 (IMP-3) were not detected in three lesions. p16 expression was higher than those of the ductular reaction, and the Ki67 and p53 indexes were very low (<1.0%). Large-sized EMA-luminal BDA shows sclerotic stroma. We classified small nodular lesions of ductal or ductular cells in chronic hepatitis and cirrhosis into the following groups: BDA, interlobular bile duct type; BDA, ductular/peribiliary gland type; and VMC-like duct. They may be reactive proliferation rather than neoplastic lesions.
authors.affiliation: Department of Pathology and Microbiology, Faculty of Medicine, Saga University, Saga, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.forename: Yuki
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Kubo
authors.forename: Ken
authors.initials: K
authors.lastname: Shirabe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Oda
mesh_terms: D002759:Adenoma, Bile Duct / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006222:Hamartoma / Q000150:complications / Q000473:pathology*; D006505:Hepatitis / Q000150:complications / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology; D008297:Male; D008875:Middle Aged
keywords: bile duct adenoma; cirrhosis; hamartoma