Tatsumi Ryoji, Ichihara Shin, Suii Hirokazu, Yamaguchi Masakatsu, Arakawa Tomohiro, Nakajima Tomoaki, Kuwata Yasuaki, Ozeki Itaru, Hige Shuhei, Toyota Joji, Karino Yoshiyasu
Department of Gastoroenterology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo, Hokkaido, 060-0033, Japan.
Department of Surgical Pathology, Sapporo Kosei General Hospital, Kita 3 Higashi 8, Chuo-ku, Sapporo, Hokkaido, 060-0033, Japan.
Jpn J Radiol. 2020 Jun;38(6):561-571. doi: 10.1007/s11604-020-00938-0. Epub 2020 Mar 3.
This study aimed to reveal characteristic imaging features of bile duct adenoma (BDA) by radiologic-pathologic correlation.
We retrospectively analyzed pathological and imaging findings of seven patients with BDA.
The median maximum diameter of BDA was 5.5 mm. Six lesions had hemispheric morphology. Seven lesions were located in the liver subcapsular region, and proliferation of bile ductules without atypia and fibrous stroma was observed. Two lesions had different microscopic findings. In both lesions, proliferation of bile ductules without atypia was observed in the margin. In one lesion, the percentage of fibrosis and hyalinization was higher at the center than at the margin. In the other lesion, inflammatory cell infiltration was observed in the center. On contrast-enhanced imaging, BDAs showed hypervascularity in the early phase and prolonged enhancement in the delayed phase. On contrast-enhanced multidetector computed tomography during hepatic arteriography, two lesions showed ring-like enhancement in the first phase and prolonged enhancement in the second phase. These were the different histopathologic features of BDAs between the margin and center.
Bile duct adenoma can be characterized as a small semicircular lesion located in the liver subcapsular region, which show hypervascularity in the early phase with prolonged enhancement.
本研究旨在通过影像学与病理学相关性揭示胆管腺瘤（BDA）的特征性影像表现。
我们回顾性分析了7例胆管腺瘤患者的病理及影像表现。
胆管腺瘤的最大直径中位数为5.5毫米。6个病灶呈半球形形态。7个病灶位于肝包膜下区域，观察到无异型性的胆小管增生和纤维性间质。2个病灶有不同的微观表现。在这两个病灶中，边缘均观察到无异型性的胆小管增生。在一个病灶中，中心的纤维化和玻璃样变性百分比高于边缘。在另一个病灶中，中心观察到炎性细胞浸润。在对比增强成像上，胆管腺瘤在早期表现为高血供，在延迟期表现为延迟强化。在肝动脉造影期间的对比增强多层螺旋CT上，2个病灶在第一期表现为环形强化，在第二期表现为延迟强化。这些是胆管腺瘤边缘和中心不同的组织病理学特征。
胆管腺瘤可表现为位于肝包膜下区域的小半圆形病灶，在早期表现为高血供并伴有延迟强化。
