Liver and intrahepatic bile ducts - tumor
Benign tumors / conditions
Bile duct adenoma

Author: Deepali Jain, M.D. (see Authors page)

Revised: 15 November 2017, last major update February 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Bile duct adenoma[TI]

See also: Atypical bile duct adenoma, clear cell type
Cite this page: Jain, D. Bile duct adenoma. website. Accessed December 14th, 2018.
Definition / general
  • Benign but not a true neoplasm
  • Incidental finding, although often confused with adenocarcinoma
  • Currently regarded as a peribiliary gland hamartoma or a localized reactive ductular proliferation due to previous unknown injury
  • Usually adults (age range 1 - 99 years), no gender preference
  • Much less common than bile duct hamartoma / von Meyenburg complex
Gross description
  • Well circumscribed but unencapsulated, firm, gray white, tan or yellow, subcapsular round to oval nodules; 85% solitary
  • May have central depression
  • Usually 5 mm or less but 7% are larger than 1 cm (0.5 cm to 1.5 cm)
  • Larger than von Meyenburg complex and smaller than cholangiocarcioma
Microscopic (histologic) description
  • Compact network of simple noncystic tubular ducts or more complex tortuous arrangement, with small or indistinct lumina
  • Epithelium has abundant cytoplasm and pale nuclei compared to interlobular bile ducts in adjacent liver
  • Rarely clear and oncocytic cells (Histopathology 2006;49:318)
  • Variable fibrous stroma
  • Center of larger lesions is paucicellular, densely collagenised; nodular lymphoid aggregate at periphery
  • Non caseating granulomas, microcalcification, inflammatory cells; normal portal tracts with bile ducts may be present
  • Usually no cystic change, no cytoplasmic or intraluminal bile, no atypia, no mitotic figures, no angiolymphatic invasion
Positive stains
Differential diagnosis
  • Adenocarcinoma: atypical cytologic and architectural features
  • Cholangiocarcioma: larger, infiltrative
  • Von Meyenburg complex: 0.5 cm or smaller, less cellular, curvilinear angulated inspissated bile containing ducts, more abundant stroma