Bhathal P S, Hughes N R, Goodman Z D
Department of Anatomical Pathology, Royal Melbourne Hospital, Victoria, Australia.
Am J Surg Pathol. 1996 Jul;20(7):858-64. doi: 10.1097/00000478-199607000-00009.
The cell phenotype of so-called bile duct adenoma (BDA) was investigated immunohistochemically using monoclonal antibodies to two recently identified antigens (designated D10 and 1F6) extracted from human liver and cultured biliary epithelium. The acini and tubules of BDA consisted of serous and mucous cells that expressed D10 and 1F6. The intrahepatic peribiliary glands of normal liver, comprising intramural mucous glands and extramural tubuloalveolar seromucinous glands, similarly expressed D10 and 1F6 antigens. Antigen 1F6 was present in the cells forming the canals of Hering and normal bile ductules but not in interlobular and larger bile ducts. Proliferating bile ductules associated with large bile duct obstruction and alcoholic cirrhosis or the epithelia of the von Meyenberg complex and polycystic liver did not exhibit this combined profile of D10 and 1F6 expression and mucous cells. These findings suggest an origin of BDA from peribiliary glands rather than from bile ductules or ducts. Consistent with this view was our finding that 18 of the 30 BDA were spatially related to a large-calibre bile duct. Therefore, BDA, well known for its benign behavior is a small mass of disorganized but mature peribiliary gland acini and tubules within a variable amount of stroma and should properly be called a peribiliary gland hamartoma.
利用针对从人肝脏和培养的胆管上皮中提取的两种最近鉴定出的抗原（命名为D10和1F6）的单克隆抗体，对所谓胆管腺瘤（BDA）的细胞表型进行了免疫组织化学研究。BDA的腺泡和小管由表达D10和1F6的浆液性和黏液性细胞组成。正常肝脏的肝内胆管周围腺体，包括壁内黏液腺和壁外小管泡状浆液黏液腺，同样表达D10和1F6抗原。抗原1F6存在于赫林管和正常胆小管的构成细胞中，但在小叶间胆管和较大胆管中不存在。与大胆管梗阻、酒精性肝硬化相关的增生胆小管，或迈耶堡复合体和多囊肝的上皮细胞，均未表现出这种D10和1F6表达及黏液性细胞的联合特征。这些发现提示BDA起源于胆管周围腺体而非胆小管或胆管。与这一观点一致的是，我们发现30例BDA中有18例在空间上与一条大口径胆管相关。因此，以其良性行为而闻名的BDA是在数量不等的间质内的一小团杂乱但成熟的胆管周围腺体腺泡和小管，应恰当地称为胆管周围腺体错构瘤。
