A case of a choledochal cyst associated with a lymphatic infiltration of a hyperplastic gallbladder epithelium

Abstract A 4-year-old girl with a congenital choledochal cyst (Todani IV-A, Komi type A) underwent a resection of the dilated common bile duct and gallbladder. Histologic studies of the gallbladder showed a general hyperplastic change associated with cribriform proliferation at the gland base of the...

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Bibliographic Details
Published in:Journal of pediatric surgery 2009-04, Vol.44 (4), p.831-835
Main Authors: Hirayama, Yutaka, Kubota, Masayuki, Hasegawa, Go, Okuyama, Naoki, Ohtaki, Masahiro, Kobayashi, Kumiko, Tsukada, Mami, Sato, Kanako, Nishikura, Ken, Naito, Makoto, Ajioka, Yoichi
Format: Article
Language:English
Subjects:
Carcinogenesis
Child, Preschool
Cholecystectomy - methods
Choledochal cyst
Choledochal Cyst - diagnosis
Choledochal Cyst - surgery
Common Bile Duct - pathology
Common Bile Duct - surgery
Diagnosis, Differential
Epithelial hyperplasia
Epithelium - pathology
Female
Follow-Up Studies
Gallbladder - pathology
Gallbladder - surgery
Gallbladder Neoplasms - diagnosis
Gallbladder Neoplasms - pathology
Humans
Hyperplasia - pathology
Immunohistochemistry
Incidental Findings
Lymphatic infiltration
Lymphatic Vessels - pathology
Lymphatic Vessels - physiopathology
Pediatrics
Risk Assessment
Surgery
Treatment Outcome
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Summary:Abstract A 4-year-old girl with a congenital choledochal cyst (Todani IV-A, Komi type A) underwent a resection of the dilated common bile duct and gallbladder. Histologic studies of the gallbladder showed a general hyperplastic change associated with cribriform proliferation at the gland base of the gallbladder. In this region, clusters of cribriform glands were found within the lymphatic vessels, compatible with lymphatic infiltration of tumor cells. However, careful histologic studies did not reveal any apparent neoplastic changes in the gallbladder and common bile duct, so a final diagnosis of epithelial atypism with reactive hypertrophy was made. The displacements observed in the lymphatics are just an incidental finding in a proliferative process of the hyperplastic gallbladder epithelium. In the follow-up observation for 3 years, the patient is doing well without evidence of tumor recurrence. These results suggest that a mere lymphatic infiltration of hyperplastic gallbladder epithelium should not be directly considered as evidence of carcinogenesis.
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2008.11.006