title: Ciliated hepatic foregut cyst: a report of 6 cases and a review of the English literature.
abstract: BACKGROUND
  Ciliated hepatic foregut cyst (CHFC) is a rare cystic lesion most commonly identified in segment 4 of the liver that arises from the embryonic foregut. The classic histologic pattern is comprised of 4 distinct layers (inner ciliated epithelial lining, smooth muscle, loose connective tissue, fibrous capsule). Although rare, cases of metaplastic and malignant epithelial lining have been described in CHFC.
  
  
  METHODS
  We report 6 additional cases of CHFC, one of which had gastric metaplasia of the cyst lining, and review all reported cases of CHFC in the English literature. We describe the clinicopathologic analysis of 6 cases, with selective immunohistochemical analysis on 1 case with gastric metaplasia.
  
  
  RESULTS
  Cases occurred in 4 women and 2 men (average age 55 years, range 42 to 67 years). Cysts ranged in size from 0.7 to 17 cm (average 7.2 cm) and were grossly tan-pink to white with blood-filled contents. The majority were located in segment 4 of the liver, however 2 were located in the porta hepatis. Tumor serologies (CA19-9 and/or CEA) were performed in 3 cases; 1 case demonstrated elevated CA19-9, and 2 cases had laboratory values within normal limits. All cases showed the classic histologic findings, however one case additionally had extensive gastric metaplasia.
  
  
  CONCLUSIONS
  In conclusion, CHFC is a rare diagnostic entity that should be considered in the differential diagnosis for cystic hepatic lesions, particularly those located in segment 4 of the liver. Metaplasia and squamous carcinoma can occur, therefore complete surgical excision is the recommended treatment.
authors.affiliation: Washington University School of Medicine, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA. kbish621@gmail.com.|Department of Obstetrics and Gynecology, Duke University School of Medicine, 40 Duke Medicine Cir #1J, Durham, NC, 27710, USA. kbish621@gmail.com.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Bishop
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA. cperrino@path.wustl.edu.
authors.forename: Carmen M
authors.initials: CM
authors.lastname: Perrino
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA. mruzinova@path.wustl.edu.
authors.forename: Marianna B
authors.initials: MB
authors.lastname: Ruzinova
authors.affiliation: Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid Avenue, Saint Louis, MO, 63110, USA. ebrunt@path.wustl.edu.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Brunt
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D002923:Cilia / Q000473:pathology; D003560:Cysts / Q000097:blood / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008107:Liver Diseases / Q000097:blood / Q000473:pathology* / Q000601:surgery; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D011237:Predictive Value of Tests; D012698:Serologic Tests
chemical_list: D015415:Biomarkers; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen