Korean J Radiol.  2010 Oct;11(5):560-565. 10.3348/kjr.2010.11.5.560.

Imaging Findings of Intrahepatic Bile Duct Adenoma (Peribiliary Gland Hamartoma): a Case Report and Literature Review

• Kim YS
• Rha SE
• Oh SN
• Jung SE
• Shin YR
• Choi BG
• Byun JY
• Jung ES
• Kim DG

• KMID: 1102582
• DOI: http://doi.org/10.3348/kjr.2010.11.5.560

Abstract

Intrahepatic bile duct adenoma is a rare benign epithelial hepatic tumor derived from bile duct cells. We report the imaging findings of a patient with bile duct adenoma, which appeared as a small heterogeneously enhancing mass with focal small cystic change on CT and MRI. Follow-up images at seven months showed a slight increase in tumor size, which could be partly explained by intratumoral hemorrhage on pathologic examination. Although rare, bile duct adenoma should be considered as a differential diagnosis of a small hypervascular tumor located in the periphery of liver. Focal cystic change and intratumoral hemorrhage may occur.

Keyword

Liver; Adenoma; Bile duct; Computed tomography (CT); Magnetic resonance (MR)

MeSH Terms

Adenoma, Bile Duct/*diagnosis/surgery
Bile Duct Neoplasms/*diagnosis/surgery
Contrast Media/diagnostic use
Female
Hamartoma/*diagnosis/surgery
Hepatectomy
Humans
Magnetic Resonance Imaging
Middle Aged
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 Dynamic contrast-enhanced CT scans and follow-up MR images in 59-year-old woman with intrahepatic bile duct adenoma. A. Unenhanced CT scan shows well-defined low density mass measuring about 1.7 cm in periphery of posteroinferior segment of right hepatic lobe (arrow). B. Dynamic contrast-enhanced CT performed on mass shows heterogeneous enhancement (arrow) during hepatic arterial phase. Focal non-enhancing cystic portion is seen in anterior portion of mass. C. On equilibrium phase, mass shows relatively persistent enhancement (arrow). D. On equilibrium phase of follow-up CT scans obtained after seven months, tumor is slightly enlarged, measuring about 2.1 cm in diameter. E. Coronal T2-weighted half fourier acquisition single shot turbo spin echo (HASTE) image revealed that lesion has heterogeneous high signal intensity (arrow) with several small areas of bright signal intensity similar to that of fluid. F. On T1-weighted image, lesion shows homogeneous hypointensity (arrow). G. On dynamic contrast-enhanced T1-weighted images with fat saturation after administration of Gd-EOB-DTPA, upper portion of mass shows focal non-enhancing cystic portion with heterogeneous enhancement in remaining portion (arrow) during hepatic arterial phase. H. Lower portion of mass located 8 mm caudad to G shows heterogeneous enhancement during hepatic arterial phase. I. On equilibrium phase, mass shows relative hypointensity in comparison with normal liver parenchyma (arrow). J. On hepatobiliary phase obtained 20 minutes after contrast injection, mass shows distinct low signal intensity (arrow). K. Gross specimen shows well-circumscribed, non-encapsulated, yellowish white, subcapsular mass (white arrows). Multiple cystic changes (arrowhead) are seen in mass and focal hemorrhagic component (open arrow) is combined. L. Microscopically, mass consists of densely packed proliferation of simple tubular ducts (arrow) combined with hemorrhage (H). Cuboidal epithelium resembles that of interlobular bile ducts without cell atypia or mitotic activity (Hematoxylin & Eosin staining, ×200).

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