Redston M S, Wanless I R
Department of Pathology, Toronto Hospital, Canada.
Mod Pathol. 1996 Mar;9(3):233-7.
von Meyenburg complexes (VMC) are dilated small bile ducts surrounded by fibrous stroma. These lesions are frequently seen at autopsy, especially in association with polycystic disease of the kidney and/or liver. The purpose of this study was to quantitate the prevalence of VMC and associated lesions, with a view to clarifying the nature of VMC. We examined the liver slides from 2843 autopsies and found 157 patients having VMC or cysts in the liver. For each of the 157 patients, and age- and gender-matched controls, VMC, hepatic cysts, and gross and microscopic renal cysts were counted and measured and autopsy reports were reviewed. VMC were found in 5.6% of adults and in 0.9% of children. Macroscopic hepatic cysts were found in 16.9% of livers that also had VMC. Of livers with hepatic cysts, 73.5% also had VMC. Adult polycystic kidney disease (APKD) was found in 11% of adults with at least one VMC and in 40% of those with four or more VMC. Among adults with APKD, VMC were found in 97% and hepatic cysts in 88%. Because APKD could account for only 11% of the patients with VMC, we suggest that VMC, in the absence of APKD, are a manifestation of a different disease, which could be genetic or secondary to inflammation or ischemia.
肝内胆管错构瘤(VMC)是由纤维基质包绕的扩张小胆管。这些病变在尸检中很常见,尤其是与肾和/或肝的多囊病相关时。本研究的目的是对VMC及相关病变的患病率进行定量分析,以阐明VMC的本质。我们检查了2843例尸检的肝脏切片,发现157例患者肝脏有VMC或囊肿。对这157例患者中的每一例,以及年龄和性别匹配的对照,计数并测量VMC、肝囊肿、肉眼及镜下肾囊肿,并查阅尸检报告。在5.6%的成年人和0.9%的儿童中发现了VMC。在同时有VMC的肝脏中,16.9%发现有肉眼可见的肝囊肿。在有肝囊肿的肝脏中,73.5%也有VMC。在至少有一个VMC的成年人中,11%发现有成人多囊肾病(APKD),在有四个或更多VMC的成年人中,40%发现有APKD。在患有APKD的成年人中,97%发现有VMC,88%发现有肝囊肿。由于APKD仅占VMC患者的11%,我们认为在没有APKD的情况下,VMC是一种不同疾病的表现,可能是遗传性的,或继发于炎症或缺血。