Biliary cystadenoma and cystadenocarcinoma pathophysiology: Difference between revisions
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Biliary cystadenomas are usually large multiloculated cystic tumours and are of two types: those with, and those without mesenchymal (ovarian-like) stroma. The ovarian-like stroma is thick consisting of compact spindle-shaped cells and supports the epithelium and is often seen exclusively in women. Microscopically the loculi are limited by single layer of cuboidal or nonciliated columnar epithelium resting on a basement membrane. At places the epithelium forms multiple polypoidal or papillary projections.<ref name="Ahanatha PillaiVelayutham2012">{{cite journal|last1=Ahanatha Pillai|first1=Sastha|last2=Velayutham|first2=Vimalraj|last3=Perumal|first3=Senthilkumar|last4=Ulagendra Perumal|first4=Srinivasan|last5=Lakshmanan|first5=Anand|last6=Ramaswami|first6=Sukumar|last7=Ramasamy|first7=Ravi|last8=Sathyanesan|first8=Jeswanth|last9=Palaniappan|first9=Ravichandran|last10=Rajagopal|first10=Surendran|title=Biliary Cystadenomas: A Case for Complete Resection|journal=HPB Surgery|volume=2012|year=2012|pages=1–6|issn=0894-8569|doi=10.1155/2012/501705}}</ref> | Biliary cystadenomas are usually large multiloculated cystic tumours and are of two types: those with, and those without mesenchymal (ovarian-like) stroma. The ovarian-like stroma is thick consisting of compact spindle-shaped cells and supports the epithelium and is often seen exclusively in women. Microscopically the loculi are limited by single layer of cuboidal or nonciliated columnar epithelium resting on a basement membrane. At places the epithelium forms multiple polypoidal or papillary projections.<ref name="Ahanatha PillaiVelayutham2012">{{cite journal|last1=Ahanatha Pillai|first1=Sastha|last2=Velayutham|first2=Vimalraj|last3=Perumal|first3=Senthilkumar|last4=Ulagendra Perumal|first4=Srinivasan|last5=Lakshmanan|first5=Anand|last6=Ramaswami|first6=Sukumar|last7=Ramasamy|first7=Ravi|last8=Sathyanesan|first8=Jeswanth|last9=Palaniappan|first9=Ravichandran|last10=Rajagopal|first10=Surendran|title=Biliary Cystadenomas: A Case for Complete Resection|journal=HPB Surgery|volume=2012|year=2012|pages=1–6|issn=0894-8569|doi=10.1155/2012/501705}}</ref> | ||
The majority of biliary cystadenomas do not communicate with the bile ducts, but luminal communication may be occasionally observed. In some of the cases, dysplastic mucinous epithelium itself may proliferate within the bile ducts causing obstruction. This variant is considered an intraductal papillary neoplasm with prominent cystic dilatation of the duct rather than a true biliary cystic neoplasm.<ref name="Ahanatha PillaiVelayutham2012">{{cite journal|last1=Ahanatha Pillai|first1=Sastha|last2=Velayutham|first2=Vimalraj|last3=Perumal|first3=Senthilkumar|last4=Ulagendra Perumal|first4=Srinivasan|last5=Lakshmanan|first5=Anand|last6=Ramaswami|first6=Sukumar|last7=Ramasamy|first7=Ravi|last8=Sathyanesan|first8=Jeswanth|last9=Palaniappan|first9=Ravichandran|last10=Rajagopal|first10=Surendran|title=Biliary Cystadenomas: A Case for Complete Resection|journal=HPB Surgery|volume=2012|year=2012|pages=1–6|issn=0894-8569|doi=10.1155/2012/501705}}</ref> | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology
Biliary cystadenomas are cystic neoplasms that may be either unilocular or multilocular. Only rarely are they found in the extrahepatic biliary tree and gallbladder (see extrahepatic biliary cystadenoma). Histologically cystadenomas are composed of multiple cysts lined by cuboidal or columnar epithelium that resembles normal biliary epithelium.
The vast majority of these neoplasms are intrahepatic (97%) with a small proportion extrahepatic (3%).
Some biliary cystadenomas may rarely develop into a cystadenocarcinoma.
Microscopic Pathology
At histologic analysis, cystadenomas have multiple loculations lined by cuboidal or columnar epithelium that resembles biliary epithelium.
Biliary cystadenomas are usually large multiloculated cystic tumours and are of two types: those with, and those without mesenchymal (ovarian-like) stroma. The ovarian-like stroma is thick consisting of compact spindle-shaped cells and supports the epithelium and is often seen exclusively in women. Microscopically the loculi are limited by single layer of cuboidal or nonciliated columnar epithelium resting on a basement membrane. At places the epithelium forms multiple polypoidal or papillary projections.[1]
The majority of biliary cystadenomas do not communicate with the bile ducts, but luminal communication may be occasionally observed. In some of the cases, dysplastic mucinous epithelium itself may proliferate within the bile ducts causing obstruction. This variant is considered an intraductal papillary neoplasm with prominent cystic dilatation of the duct rather than a true biliary cystic neoplasm.[1]
References
- ↑ 1.0 1.1 Ahanatha Pillai, Sastha; Velayutham, Vimalraj; Perumal, Senthilkumar; Ulagendra Perumal, Srinivasan; Lakshmanan, Anand; Ramaswami, Sukumar; Ramasamy, Ravi; Sathyanesan, Jeswanth; Palaniappan, Ravichandran; Rajagopal, Surendran (2012). "Biliary Cystadenomas: A Case for Complete Resection". HPB Surgery. 2012: 1–6. doi:10.1155/2012/501705. ISSN 0894-8569.