Bile duct adenoma

No excess of cancer was reported in two follow-up smdies of affected individuals in Turkey about 20-30 years after consumption of contaminated grain had ceased. " In mice, liver tumors were observed after exposure to HCB at 12-24mg/kg/day in the diet, but not at 6mg/kg/day. Hepatomas, hepatocellular carcinomas, bile duct adenomas, and renal cell adenomas were observed in rats after dietary administration." Liver tumors were also observed in 100% of surviving females and 16% of males after dietary administration to rats for 90 weeks. In another study, increased incidence of parathyroid adenomas and adrenal pheochromocytomas were observed in male and female rats and liver neoplastic nodules in females of the Ei generation in a two-generation feeding study. 

Chronic oral exposure of rats and mice to MDA and its dihydrochloride is carcinogenic. Treatment-related increases in the incidences of thyroid follicular cell adenomas and hepatocellular neoplasms were observed in mice after chronic ingestion of MDA in drinking water. In rats, increases in the incidences of thyroid follicular cell carcinoma and hepatic nodules were observed in males and thyroid follicular cell ademonas occurred in females. Although not statistically significant, certain uncommon tumors such as bile duct adenomas, papillomas of the urinary bladder, and granulosa cell tumors of the ovary also were reported. These tumors are of low incidence in historical controls. In another report, MDA acted as a promoter of thyroid tumors in rats. °... 

Bile-duct papillomatosis Biliary hamartoma Caroli s disease/syndrome Intrahepatic bile-duct adenoma Intrahepatic bile-duct cystadenoma... 

Bile-duct adenomas are rare. Usually, they are solitary and < 2 cm in size. This type of adenoma is more often detected in men than in women (3 1) and it occurs in patients mainly over the age of 50. It is nearly always localized beneath the liver capsule. This adenoma has the form of a firm, whitish node and consists of bile-duct proliferations. It contains biliary acini and tubules which are lined with a layer of cuboid epithelium within loose fibrous, partially hyaline stroma. There is evidence of mononuclear inflammatory cells and, occasionally, lymph follicles. It is discussed that such biliary adenomas are peribiliary gland hamartomas. (162) There are no clinical or biochemical abnormalities, nor is there any tendency towards malignant degeneration. (161,163)... 

Bhathal, P.S., Hughes, N.R., Goodman, Z.D. The so-called bile duct adenoma is a peribiliary gland hamartoma. Amer. X. Surg. Pathol. 1996 20 858-864... 

Tajima, T., Honda, H., Kuroiwa, T., Yoshimitsu, K., Irie, H., Aibe, H., Taguchi, K., Shimada, M., Masuda, K. Radiologic features of intra-hepatic bile duct adenoma a look at the surface of the liver. X. Corn-put. Assist. Tomogr. 1999 23 690—695... 

Bile Duct Hamartoma and Bile Duct Adenoma... 

O Hara BJ, McCue PA, Miettinen M. Bile duct adenomas with endocrine component. Immunohistochemical study and comparison with conventional bile duct adenomas. Am J Surg Pathol. 1992 16 21-25. 

In 2-year gavage studies there was some evidence of carcinogenic activity in male rats based on increased incidences of cholangiocar-cinomas and bile duct dysplasia and fibrosis. There was also some evidence of carcinogenicity in female mice based on increased incidences of hepatocellular adenomas. Male mice showed clear evidence of carcinogenicity based on increased incidences of hepatocellular adenomas and carcinomas. The development of liver tumors may be related to the chronic inflammatory effects noted at this site. In another experiment with hamsters, exposure to furfural vapor 7 hours/day, 5 days/week for 1 year caused irritation of the nasal mucosa and growth retardation but no evidence of carcinogenic effects. ... 

Hepatic adenoma consists of atypical, strand-like hepa-tocytes. It is characterized by normal perfusion and an extensive absence of Kupffer cells as well as irregularity of the bile ducts. Scintigraphically, it is possible to demonstrate that there is no elimination of iminodiacetates from the adenoma and that uptake of the radioactive tracer is prolonged compared with the normal liver parenchyma ( trapping on IDA scans). (38) No colloidal albumin or Tc-colloid is taken up - this allows differentiation of an adenoma from focal nodular hyperplasia. The use of the SPECT technique increases sensitivity. 

Regeneration after liver resection follows a coordinated and limited course. This is not the case in cirrhosis isolated and excessive regenerations of hepatocytes and bile ducts are formed, from which adenomas and carcinomas may develop. 

Most adenomas of the extrahepatic biliary tract (EHBT) occur in the gallbladder and are usually detected incidentally." In contrast, those in the extrahepatic bile ducts (EHBDs) present with signs and symptoms of obstruction. They can be multifocal, especially those with a papillary architecture. On the basis of the growth pattern, they have been classihed traditionally as tubular, papillary, or tubulopapillary, although the relevance of this classihcation independent of the degree of dysplasia is debatable. ... 

Bile Duct Cyst Adenoma or Hepatobiliary Cystadenoma 81... 

Adenoma cells are arranged in cords and separated by sinusoids (Ishak 1994). The tumor lacks portal tracts or bile ducts, a key histological feature that helps distinguish hepatocellular adenoma from focal nodular hyperplasia (Boulahdour et al. 1993). Kupffer s cells are found in adenomas but probably they are often decreased in number or less functional than normal liver tissue, as reflected by absent or diminished uptake of technetium (Tc)-99m sulfur colloid (Fig. 10.1) (Rubin and Lichtenstein 1993). Because this neoplasm has no portal tracts, the tumor perfusion occurs solely by peripheral arterial feeders therefore the hypervascular nature of adenoma, related to sinusoids and feeding arteries, associated with poor connective tissue support, can lead frequently to hemorrhage. Because a tumor capsule is usually absent or incomplete, hemorrhage may spread into the liver or abdominal cavity (Molina and ScHiFF 1999). 

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