Liver & intrahepatic bile ducts
Benign / nonneoplastic
Bile duct adenoma
Author: Deepali Jain, M.D.
Topic Completed: 1 February 2002
Minor changes: 22 September 2020
Copyright: 2002-2021, 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 style answer #1Cite this page: Jain D. Bile duct adenoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/livertumorbileductadenoma.html. Accessed January 22nd, 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
- 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 #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 style answer #1
A. May show a lymphocytic cuff
