Abstract
The aim of this study was to review the clinical, radiographic, and pathologic features of cases of benign segmental cholangiectasia in non-Asian US patients with clinical concern for cholangiocarcinoma and compare these features with cases of recurrent pyogenic cholangitis (RPC) in Asian patients. A total of 10 non-Asian US patients with benign segmental cholangiectasia were included in this study. Nine of them underwent partial hepatic resection due to cholangiographic findings of segmental cholangiectasia with mural thickening and/or proximal biliary stricture. One was found to have markedly dilated and thickened intrahepatic bile ducts at the time of autopsy. Clinical and radiographic findings were reviewed. Elastin stains and immunostains for immunoglobulin G4, cluster of differentiation (CD1a), and Langerin were performed. Six comparison cases of RPC in Asian US patients were also examined. Histologic examination of resection specimens revealed markedly dilated large intrahepatic bile ducts with variable degrees of mural fibrosis, periductal gland hyperplasia, inflammation, and liver parenchymal atrophy. These changes were not associated with a ductular reaction. There was no evidence of biliary dysplasia or biliary cirrhosis in any cases. No gross or microscopic feature definitively separated the Asian from non-Asian patients. The etiology of this disorder in non-Asian US patients is unclear. It does not appear to represent a localized variant of Caroli disease or primary sclerosing cholangitis. The high degree of similarity shared by these cases and classic RPC suggests a common pathogenic mechanism, although the pathologic features tend to be less well developed in the cases from the non-Asian US patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 426-433 |
| Number of pages | 8 |
| Journal | Human Pathology |
| Volume | 46 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2015 |
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Keywords
- Cholangiectasia
- Hepatolithiasis
- Recurrent pyogenic cholangitis
- Sclerosing cholangitis
ASJC Scopus subject areas
- Pathology and Forensic Medicine
- Medicine(all)
Cite this
Segmental cholangiectasia clinically worrisome for cholangiocarcinoma : Comparison with recurrent pyogenic cholangitis. / Zhao, Lei; Hosseini, Mojgan; Wilcox, Rebecca; Liu, Qiang; Crook, Terri; Taxy, Jerome B.; Ferrell, Linda; Hart, John.
In: Human Pathology, Vol. 46, No. 3, 01.03.2015, p. 426-433.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Segmental cholangiectasia clinically worrisome for cholangiocarcinoma
T2 - Comparison with recurrent pyogenic cholangitis
AU - Zhao, Lei
AU - Hosseini, Mojgan
AU - Wilcox, Rebecca
AU - Liu, Qiang
AU - Crook, Terri
AU - Taxy, Jerome B.
AU - Ferrell, Linda
AU - Hart, John
PY - 2015/3/1
Y1 - 2015/3/1
N2 - The aim of this study was to review the clinical, radiographic, and pathologic features of cases of benign segmental cholangiectasia in non-Asian US patients with clinical concern for cholangiocarcinoma and compare these features with cases of recurrent pyogenic cholangitis (RPC) in Asian patients. A total of 10 non-Asian US patients with benign segmental cholangiectasia were included in this study. Nine of them underwent partial hepatic resection due to cholangiographic findings of segmental cholangiectasia with mural thickening and/or proximal biliary stricture. One was found to have markedly dilated and thickened intrahepatic bile ducts at the time of autopsy. Clinical and radiographic findings were reviewed. Elastin stains and immunostains for immunoglobulin G4, cluster of differentiation (CD1a), and Langerin were performed. Six comparison cases of RPC in Asian US patients were also examined. Histologic examination of resection specimens revealed markedly dilated large intrahepatic bile ducts with variable degrees of mural fibrosis, periductal gland hyperplasia, inflammation, and liver parenchymal atrophy. These changes were not associated with a ductular reaction. There was no evidence of biliary dysplasia or biliary cirrhosis in any cases. No gross or microscopic feature definitively separated the Asian from non-Asian patients. The etiology of this disorder in non-Asian US patients is unclear. It does not appear to represent a localized variant of Caroli disease or primary sclerosing cholangitis. The high degree of similarity shared by these cases and classic RPC suggests a common pathogenic mechanism, although the pathologic features tend to be less well developed in the cases from the non-Asian US patients.
AB - The aim of this study was to review the clinical, radiographic, and pathologic features of cases of benign segmental cholangiectasia in non-Asian US patients with clinical concern for cholangiocarcinoma and compare these features with cases of recurrent pyogenic cholangitis (RPC) in Asian patients. A total of 10 non-Asian US patients with benign segmental cholangiectasia were included in this study. Nine of them underwent partial hepatic resection due to cholangiographic findings of segmental cholangiectasia with mural thickening and/or proximal biliary stricture. One was found to have markedly dilated and thickened intrahepatic bile ducts at the time of autopsy. Clinical and radiographic findings were reviewed. Elastin stains and immunostains for immunoglobulin G4, cluster of differentiation (CD1a), and Langerin were performed. Six comparison cases of RPC in Asian US patients were also examined. Histologic examination of resection specimens revealed markedly dilated large intrahepatic bile ducts with variable degrees of mural fibrosis, periductal gland hyperplasia, inflammation, and liver parenchymal atrophy. These changes were not associated with a ductular reaction. There was no evidence of biliary dysplasia or biliary cirrhosis in any cases. No gross or microscopic feature definitively separated the Asian from non-Asian patients. The etiology of this disorder in non-Asian US patients is unclear. It does not appear to represent a localized variant of Caroli disease or primary sclerosing cholangitis. The high degree of similarity shared by these cases and classic RPC suggests a common pathogenic mechanism, although the pathologic features tend to be less well developed in the cases from the non-Asian US patients.
KW - Cholangiectasia
KW - Hepatolithiasis
KW - Recurrent pyogenic cholangitis
KW - Sclerosing cholangitis
UR - http://www.scopus.com/inward/record.url?scp=84924628421&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924628421&partnerID=8YFLogxK
U2 - 10.1016/j.humpath.2014.11.019
DO - 10.1016/j.humpath.2014.11.019
M3 - Article
VL - 46
SP - 426
EP - 433
JO - Human Pathology
JF - Human Pathology
SN - 0046-8177
IS - 3
ER -