Liver & intrahepatic bile ducts
Benign / nonneoplastic
Bile duct adenoma
Author: Deepali Jain, M.D.
Topic Completed: 1 February 2002
Minor changes: 1 August 2020
Copyright: 2002-2019, PathologyOutlines.com, Inc.
PubMed Search: Bile duct adenoma[TI]
Table of Contents
Definition / general | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosis | Board review style question #1 | Board review answer #1Cite this page: Jain D. Bile duct adenoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/livertumorbileductadenoma.html. Accessed August 6th, 2020.
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
- 44 year old man with incidental 1 cm nodule on anterior surface of liver (Case of the Week #475)
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 of the Week #475:
EMA
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
A. May show a lymphocytic cuff
B. May show prominent nuclear atypia
C. Typically >1 cm in size
D. Typically multifocal
Board review answer #1
A. May show a lymphocytic cuff
