title: Peribiliary hepatic cysts presenting as hilar cholangiocarcinoma in a patient with end-stage liver disease.
abstract: Peribiliary cysts are cystic dilatations of peribiliary glands in the liver. They are present in ~50% of cirrhotic patients, but are underrecognized because they are usually asymptomatic and rarely present as obstructive jaundice. A 63-year-old male with hepatitis C cirrhosis, awaiting liver transplantation, had a new finding of intrahepatic dilatation on magnetic resonance imaging. This was initially concerning for cholangiocarcinoma, but was ultimately diagnosed as peribiliary cysts. Peribiliary cysts can imitate cholangiocarcinoma on imaging. Therefore, awareness of this condition is essential because misdiagnosis may lead to inappropriate delay or denial for liver transplantation. The ideal imaging modalities to identify peribiliary cysts are magnetic resonance cholangiography and drip infusion cholangiographic computed tomography, though hepatic dysfunction may limit the usefulness of the latter. Peribiliary cysts should be considered in cirrhotic patients with cholestasis, biliary dilatations and negative biopsy of the biliary system for malignancy.
authors: Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Jane
authors: J
authors: Lim
authors: Department of Surgery and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Nicholas N
authors: NN
authors: Nissen
authors: Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Christopher
authors: C
authors: McPhaul
authors: Department of Surgery and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Alagappan
authors: A
authors: Annamalai
authors: Department of Surgery and Comprehensive Transplant Center, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors: Andrew S
authors: AS
authors: Klein
authors: Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA Vinay.Sundaram@cshs.org vinaysundaram@yahoo.com.
authors: Vinay
authors: V
authors: Sundaram