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Uski ACVR, Pedroso MHNI, Abud CP, Costa MM, Ferreira MPFD. Peribiliary cysts: uncommon mimickers of hepatic and biliary cystic lesions. Abdom Radiol (NY) 2024:10.1007/s00261-024-04472-9. [PMID: 38951232 DOI: 10.1007/s00261-024-04472-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/21/2024] [Accepted: 06/22/2024] [Indexed: 07/03/2024]
Abstract
Peribiliary cysts (PC) are dilatations of the extramural peribiliary glands, with a very characteristic imaging pattern in the contexts of hepatobiliary diseases, idiopathic portal hypertension, adult-type polycystic disease of the liver and kidneys, solitary nonparasitic cysts, and systemic infections. The clinical relevance of PC is related to the fact that their presence may indicate underlying pathologies (such as those mentioned above) and may be considered as a potential marker of liver disease progression. Although imaging findings are quite characteristic, recognizing their main differential diagnoses, including malignancies, can be challenging but are essential to avoiding diagnostic errors.
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Affiliation(s)
- Ana Cláudia Vincenzi Raduan Uski
- Abdominal and Oncoradiology Department, A Beneficência Portuguesa de São Paulo, R. Maestro Cardim 769, São Paulo, SP, 01323-001, Brazil.
| | - Maria Helena Naves Inácio Pedroso
- Abdominal and Oncoradiology Department, A Beneficência Portuguesa de São Paulo, R. Maestro Cardim 769, São Paulo, SP, 01323-001, Brazil
| | - Carolina Pereira Abud
- Abdominal and Oncoradiology Department, A Beneficência Portuguesa de São Paulo, R. Maestro Cardim 769, São Paulo, SP, 01323-001, Brazil
| | - Marina Martini Costa
- Abdominal and Oncoradiology Department, A Beneficência Portuguesa de São Paulo, R. Maestro Cardim 769, São Paulo, SP, 01323-001, Brazil
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Choe MJ, Hinkel T, Berggruen SM. Imaging of Benign Hepatic lesions. Semin Ultrasound CT MR 2021; 42:347-365. [PMID: 34130848 DOI: 10.1053/j.sult.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
As abdominal imaging volumes have increased, the incidence of incidentally identified benign hepatic lesions has substantially increased. Familiarity with imaging appearances of benign hepatic tumors, both common and less commonly encountered, allows the radiologist to give an informed differential diagnosis. In addition to clinical history, awareness of imaging findings of benign hepatic lesions on ultrasound, computed tomography and magnetic resonance imaging is useful in evaluating these lesions and avoiding unnecessary diagnostic interventions or imaging surveillance.
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Affiliation(s)
- Michael J Choe
- Department of Radiology, Northwestern Memorial Hospital, Chicago, IL
| | - Tyler Hinkel
- Department of Radiology, Northwestern Memorial Hospital, Chicago, IL
| | - Senta M Berggruen
- Department of Radiology, Northwestern Memorial Hospital, Chicago, IL..
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AlNuaimi D, Balci NC, AlDuaij A, AlKetbi R, Sierra MPR. A case of peribiliary hepatic cysts in a cirrhotic liver: A mimicker of Klatskin Tumor. Radiol Case Rep 2020; 15:1039-1043. [PMID: 32435324 PMCID: PMC7231818 DOI: 10.1016/j.radcr.2020.04.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 01/13/2023] Open
Abstract
Patients with end-stage liver disease may present to healthcare facilities with features of obstructive jaundice and a picture of hilar cholangiocarcinoma on radiological imaging. Careful observation and knowledge of the presence and higher prevalence of peribiliary hepatic cysts in a cirrhotic liver can aid in differentiating this benign entity from malignancy that may halt or delay the patients’ eligibility for receiving a liver transplant. We present a case of a patient with liver cirrhosis initially diagnosed as Klatskin tumor on imaging then as a simple case of multiple peribiliary hepatic cysts with the patient eventually undergoing successful liver transplantation.
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Affiliation(s)
- Dana AlNuaimi
- Imaging Institute Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates
| | - Numan Cem Balci
- Imaging Institute Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates
| | - Ahmad AlDuaij
- National Reference Laboratory, Abu Dhabi, United Arab Emirates
| | - Reem AlKetbi
- Rashid Hospital, Dubai Health Authority, PO Box 4545, Dubai, United Arab Emirates
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Kim HJ, Kim CY, Hur YH, Kim JC, Cho CK, Kim HJ. Peribiliary cysts developed in normal underlying liver: report of a case. KOREAN JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY 2013; 17:131-4. [PMID: 26155227 PMCID: PMC4304523 DOI: 10.14701/kjhbps.2013.17.3.131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 07/30/2013] [Accepted: 08/05/2013] [Indexed: 11/20/2022]
Abstract
Peribiliary cysts, known as cystic dilatation, of the extramural peribiliary glands of the bile duct are rare, and are usually detectable under conditions of pre-existing hepatobiliary diseases such as liver cirrhosis. Preoperative diagnosis is often difficult, because they are usually asymptomatic. Distinction of peribiliary cysts from premalignant or malignant cystic lesions is mandatory. Herein, we report a case of peribiliary cyst, which was preoperatively assumed as unilobar Caroli's diseases in healthy young patients and briefly discuss the management of the condition.
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Affiliation(s)
- Hee Joon Kim
- Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea
| | - Choong Young Kim
- Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea
| | - Young Hoe Hur
- Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea
| | - Jung Chul Kim
- Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea
| | - Chol Kyoon Cho
- Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea
| | - Hyun Jong Kim
- Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea
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Ikenaga N, Chijiiwa K, Otani K, Ohuchida J, Uchiyama S. A case of peribiliary cyst presenting with obstructive jaundice. J Gastrointest Surg 2009; 13:174-6. [PMID: 18071835 DOI: 10.1007/s11605-007-0431-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2007] [Accepted: 11/09/2007] [Indexed: 01/31/2023]
Abstract
A 77-year-old woman with a complaint of itching was shown to have an elevated serum bilirubin level. She had no history of liver disease. Computed tomography and magnetic resonance cholangiopancreatography revealed a 17-mm-diameter cystic lesion obstructing the main hepatic duct at the hepatic hilum. Drip infusion cholangiographic computed tomography and endoscopic retrograde cholangiography showed that the cyst did not communicate with the biliary tree; thus, a peribiliary cyst was diagnosed. Cystectomy was performed, and the jaundice resolved. Peribiliary cysts are generally asymptomatic and rarely cause obstructive jaundice. They are usually multiple and caused by an underlying liver disorder with a poor prognosis. Our case suggests that peribiliary cysts can arise in healthy liver and cause symptoms. Cystectomy is the treatment of choice if the cyst is solitary.
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Affiliation(s)
- Naoki Ikenaga
- Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
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Histopathological Distinction and Evaluation of Biliary and Peribiliary Cysts in Pig Liver. J Comp Pathol 2008; 139:202-7. [DOI: 10.1016/j.jcpa.2008.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 06/23/2008] [Accepted: 07/09/2008] [Indexed: 11/23/2022]
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Yu CH, Kim KT, Hwang DN, Yhee JY, Moon CT, Hur TY, Sur JH. Peribiliary cysts associated with severe liver disease: a previously unrecognized tumor in a lion (Panthera leo). J Vet Diagn Invest 2007; 19:709-12. [PMID: 17998564 DOI: 10.1177/104063870701900617] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A 13-year-old male lion (Panthera leo) from Dae Jeon Zoo, Republic of Korea, presented with clinical signs of lethargy and anorexia. Despite treatment with antibiotics and fluid therapy, the lion died 6 days after initial presentation. Postmortem examination revealed multiple masses measuring 5-10 cm in diameter and cysts throughout the liver. A diagnosis of spontaneous peribiliary cysts was made on the basis of microscopic lesions as well as special staining and immunohistochemical characteristics. Histologically, the neoplasm was surrounded and composed of compact collagenous tissue. The inner cystic single layer resembled biliary mucosa and was composed of cuboidal or flattened epithelial lining that was strongly immunopositive for cytokeratin AE1/AE3. This layer was surrounded by fibrous tissue that stained blue by Masson's trichrome staining. Given the presence of multiple organized cysts in the liver, the lesion was consistent with peribiliary cysts. To the authors' knowledge, this is the first report of peribiliary cysts in an animal.
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Affiliation(s)
- Chi-Ho Yu
- Department of Veterinary Pathobiology, Small Animal Tumor Diagnostic Center, College of Veterinary Medicine, Konkuk University, KwangJin-Ku, Seoul 143-701, Korea
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Komine M, Kawasako K, Akihara Y, Shimoyama Y, Okamoto M, Matsuda K, Hirayama K, Taniyama H. Multiple hepatic peribiliary cysts in a young pig. Vet Pathol 2007; 44:707-9. [PMID: 17846247 DOI: 10.1354/vp.44-5-707] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Histopathologic features of hepatic peribiliary cysts were described in a young slaughtered pig. The animal was an apparently healthy 6-month-old pig of mixed breed. Macroscopically, all lobes of the liver contained numerous cysts of varying size containing serous fluid in all lobes. Histopathologically, the cysts were located mainly around the large bile duct and in the connective tissue of the portal tracts. Within serial sections, these cysts were assumed to be solitary or multilocular, but they were separated from the bile duct. The cysts were lined by a single layer of columnar, cuboidal, and flattened epithelial cells. Occasionally, goblet cells were observed. The epithelial cells were stained with periodic acid-Schiff/alcian blue and high-iron diamine/alcian blue, indicating the presence of neutral mucin, sialomucin, and sulfomucin. Grimalius' method revealed the presence of endocrine cells in the lining epithelium. There was no bile pigment in the cysts by the Hall method.
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Affiliation(s)
- M Komine
- Department of Veterinary Pathology, School of Veterinary Medicine, Rakuno Gakuen University, 582-1 Bunkyodai-Midorimachi, Ebetsu, Hokkaido 069-8501, Japan
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Kai K, Eguchi Y, Kumagai T, Sugita Y, Tokunaga O. An autopsy case of obstructive jaundice due to hepatic multiple peribiliary cysts accompanying hepatolithiasis. Hepatol Res 2007; 38:211-6. [PMID: 17645517 DOI: 10.1111/j.1872-034x.2007.00211.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
A 73-year-old Japanese male, who had a history of alcoholic cirrhosis, was admitted to Saga University Hospital to receive treatment for hepatocellular carcinoma. The patient was treated to maintain his liver function, however, the total bilirubin level continued to increase gradually. Endoscopic retrograde cholangiography demonstrated an obstruction of the bilateral intrahepatic ducts. Although endoscopic nasobiliary drainage was performed, the patient died two months after admission. At the autopsy, multiple peribiliary cysts were found to almost completely obstruct the bilateral intrahepatic bile ducts. In addition, hepatolithiasis was found in the right hepatic duct. To date, only a few such cases of multipleperibiliary cysts with obstructive jaundice have been reported, and no such case accompanied by hepatolithiasis. It is also important to note that all the reported cases resulted in a poor prognosis. We herein report a very rare autopsy case with obstructive jaundice due to multiple peribiliary cysts accompanying hepatolithiasis. Generally, multiple peribiliary cysts are considered to be clinically harmless, but once they cause obstructive jaundice, their presence suggests the occurrence of end-stage cirrhosis and a poor prognosis.
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Affiliation(s)
- Keita Kai
- Departments of Pathology and Biodefense, and Surgery, Saga University Faculty of Medicine, Saga, Japan
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Miura F, Takada T, Amano H, Yoshida M, Isaka T, Toyota N, Wada K, Takagi K, Kato K. A case of peribiliary cysts accompanying bile duct carcinoma. World J Gastroenterol 2006; 12:4596-8. [PMID: 16874882 PMCID: PMC4125657 DOI: 10.3748/wjg.v12.i28.4596] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A rare case of peribiliary cysts accompanying bile duct carcinoma is presented. A 54-year-old man was diagnosed as having lower bile duct carcinoma and peribiliary cysts by diagnostic imaging. He underwent pylorus preserving pancreatoduodenectomy. As for the peribiliary cysts, a course of observation was taken. Over surgery due to misdiagnosis of patients with biliary malignancy accompanied by peribiliary cysts should be avoided.
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Affiliation(s)
- Fumihiko Miura
- Department of Surgery, Teikyo University, School of Medicine, Itabashi-ku, Tokyo 173-8605, Japan.
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