Liver and intrahepatic bile ducts - tumor
Benign tumors / conditions
Reactive bile ductule proliferation

Topic Completed: 1 February 2012

Revised: 25 January 2019, last major update February 2012

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

PubMed Search: Reactive bile ductule proliferation

Deepali Jain, M.D.
Page views in 2018: 1,856
Page views in 2019 to date: 2,162
Cite this page: Jain D. Reactive bile ductule proliferation. website. Accessed November 17th, 2019.
Definition / general
  • Bile ductular proliferation due to ductular metaplasia of hepatocytes and from proliferation of preexisting bile ductules
  • Associated with cirrhosis, submassive hepatic necrosis, biliary tract disorders, atrophy and focal nodular hyperplasia
Gross description
  • Often multiple irregular nodules
Microscopic (histologic) description
  • Periductular neutrophils common
  • No angulated structures, usually no dense fibrosis (except with atrophy), variable bile in portal tract or periportal area
Positive stains
Differential diagnosis
  • Adenocarcinoma: particularly confusing after chemotherapy, has more severe atypia with irregular nuclear membranes, prominent nucleoli, hyperchromasia, increased N/C ratio, desmoplasia, infiltrative cells
  • Bile duct adenoma: solitary, subcapsular, with collapsed lumina, prominent lymphocytes
  • Bile duct hamartoma: angulated ducts embedded in sclerotic stroma
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