Sato Yasunori, Kitagawa Satoshi, Zen Yoh, Minato Hiroshi, Nakanuma Yasuni
Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
Pathol Int. 2006 Jun;56(6):340-4. doi: 10.1111/j.1440-1827.2006.01969.x.
The ciliated hepatic foregut cyst (CHFC) is a rare lesion that may arise from remnants of the embryonic foregut. Its wall is lined by pseudostratified ciliated columnar epithelium, and is characterized by the presence of bundles of smooth muscle. Herein is presented two cases of ciliated hepatic cyst without smooth muscle layer. One case was an incidental autopsy finding, and the other was a surgically resected cystic lesion of the liver. Both cysts were <2.0 cm in diameter, and were located subcapusularly in the medial segment (S4) of the liver. The histological appearance of the two cases was identical. They had an epithelial lining of ciliated pseudostratified cells with occasional goblet cells, and lacked a smooth muscle layer, as shown by the actin immunostaining. The lining epithelium contained cells positive for immunohistochemical staining of surfactant apoprotein A, suggesting the embryonic foregut origin of the cysts and differentiation toward bronchiolar structures, rather than ciliated metaplasia of the epithelium of the simple (cholangiogenic) cyst. It is considered that ciliated hepatic cysts of the present case are a rare histological variant of CHFC where the smooth muscle layer is inconspicuous or absent.
纤毛肝前肠囊肿（CHFC）是一种罕见的病变，可能起源于胚胎前肠的残余物。其壁由假复层纤毛柱状上皮衬里，其特征是存在平滑肌束。本文介绍了两例无平滑肌层的纤毛肝囊肿。一例是尸检偶然发现，另一例是手术切除的肝脏囊性病变。两个囊肿直径均<2.0 cm，位于肝内侧段（S4）的被膜下。两例的组织学表现相同。它们有一层由纤毛假复层细胞衬里，偶尔有杯状细胞，并且缺乏平滑肌层，肌动蛋白免疫染色显示如此。衬里上皮包含表面活性物质载脂蛋白A免疫组化染色阳性的细胞，提示囊肿起源于胚胎前肠并向细支气管结构分化，而非单纯（胆管源性）囊肿上皮的纤毛化生。认为本病例的纤毛肝囊肿是CHFC的一种罕见组织学变异型，其中平滑肌层不明显或缺失。
