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Liver and intrahepatic bile ducts - tumor

Benign tumors/conditions

Benign cystic mesothelioma


Reviewers: Deepali Jain, M.D. (see Reviewers page)
Revised: 9 January 2013, last major update February 2012
Copyright: (c) 2004-2013, PathologyOutlines.com, Inc.

See similar topic in Small bowel chapter

General
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● Very rare in liver; considered reactive due to its association with abdominal surgery and endometriosis
● Also called multilocular peritoneal inclusion cyst, multifocal peritoneal inclusion cyst, benign muticystic peritoneal mesothelioma
● Arises from undifferentiated mesothelial or submesothelial cells over liver capsule (Arch Pathol Lab Med 2001;125:944)
● Female predominance, may be due to hormonal changes (Am J Surg Pathol 2002;26:1523)
Laboratory: elevated CA 19-9 in serum and cyst fluid

Treatment
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● Excision; indolent, slowly progressive and curable, but may recur

Case reports
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● 51 year old woman (Am J Surg Pathol 2002;26:1523)
● 58 year old man with elevated CA 19-9, multiple benign appearing liver cysts and single cysts in kidney and pancreas (Arch Pathol Lab Med 2001;125:944)

Gross description
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● Partially cystic, encapsulated mass with soft-glistening surface

Gross images
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Cyst before and after aspiration

Micro description
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● Well-encapsulated, partially cystic and highly vascular; no cirrhosis
● Loose cords of tumor cells separated by medium to large vessels with walls of varying thickness
● Cystic spaces lined by tumor cells, either epithelioid or with hobnail appearance

Micro images
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Various images and immunostains

Positive stains
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● CK8/18 (CAM 5.2), calretinin, EMA, vimentin and estrogen receptor

Electron microscopy description
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● Desmosomes and microvilli

Differential diagnosis
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Biliary cystadenoma
● Congenital mesothelial cyst: usually neonates (Pediatr Surg Int 2008;24:463)
● Cystic neoplasms
Hydatid cyst
● Serous cystadenoma
● Vascular neoplasms (due to high vascularity)

End of Liver and intrahepatic bile ducts - tumor > Benign tumors/conditions > Benign cystic mesothelioma


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