Liver & intrahepatic bile ducts

Benign / nonneoplastic

Bile duct adenoma

Topic Completed: 1 February 2002

Minor changes: 14 October 2021

Copyright: 2002-2021,, Inc.

PubMed Search: Bile duct adenoma[TI]

Deepali Jain, M.D.
Page views in 2020: 8,426
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Cite this page: Jain D. Bile duct adenoma. website. Accessed December 8th, 2021.
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
Case reports
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
Microscopic (histologic) images

Contributed by Drs. Saroona Haroon and Saifaldin M. Alzain, Case #475


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
Board review style question #1
Which of the following is true about these lesions?

A. May show a lymphocytic cuff
B. May show prominent nuclear atypia
C. Typically >1 cm in size
D. Typically multifocal
Board review style answer #1
A. May show a lymphocytic cuff

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