Zen Yoh, Terahata Shintaro, Miyayama Shiro, Mitsui Takeshi, Takehara Akira, Miura Shouji, Nobata Koji, Kitao Azusa, Kakuda Kiyoshi, Kiyohara Kaoru, Nakanuma Yasuni
Division of Pathology, Kanazawa University Hospital, Kanazawa 920-8641, Japan.
Hum Pathol. 2006 Mar;37(3):339-44. doi: 10.1016/j.humpath.2005.11.008.
In this report, we presented 3 cases of unusual hamartomatous nodules of the liver. These nodules were located around hepatic capsule of the left hepatic lobe and characteristically protruded from the liver. Histologically, these nodular lesions consisted of ductal structures, periductal glands, and fibrous connective tissues containing blood vessels. Smooth muscle bundles focally surrounded ductal structures. Bile-like materials were observed within some ducts. Two cases were associated with xanthogranulomatous inflammation around bile-like materials, and this inflammatory process extended from ductal lumens to periductal connective tissues. In contrast, the remaining case, which was not associated with inflammation, showed a honeycomb appearance. Ductal epithelium and periductal glands resembled biliary epithelium and peribiliary glands, respectively, and they also expressed biliary-type cytokeratins such as cytokeratins 7 and 19. These nodules shared pathologic characteristics of ciliated hepatic foregut cysts, such as their location (around the falciform ligament) and periductal smooth muscle bundles, but did not fulfill the diagnostic criteria (no ciliated cells and multilocular lesions). These hamartomatous nodules of the liver did not fit into any of the described categories of hepatic nodular lesions. At present, we speculate that these lesions might be related to developmental abnormalities of the biliary tract or embryonal foregut.
在本报告中，我们展示了3例不寻常的肝脏错构瘤结节。这些结节位于左肝叶肝包膜周围，其特征是从肝脏突出。组织学上，这些结节性病变由导管结构、导管周围腺体和含有血管的纤维结缔组织组成。平滑肌束局部围绕导管结构。在一些导管内观察到胆汁样物质。2例与胆汁样物质周围的黄色肉芽肿性炎症相关，且这种炎症过程从导管腔延伸至导管周围结缔组织。相比之下，其余1例未伴有炎症的病例呈现蜂窝状外观。导管上皮和导管周围腺体分别类似于胆管上皮和胆管周围腺体，并且它们还表达胆管型细胞角蛋白，如细胞角蛋白7和19。这些结节具有纤毛肝前肠囊肿的病理特征，如它们的位置（镰状韧带周围）和导管周围平滑肌束，但不符合诊断标准（无纤毛细胞和多房性病变）。这些肝脏错构瘤结节不符合任何已描述的肝结节性病变类别。目前，我们推测这些病变可能与胆道或胚胎前肠的发育异常有关。
