Adenomyomatous Hyperplasia of the Common Bile Duct: Report of a Case |
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Authors: | Kentaro Iwaki Kohei Shibata Masayuki Ohta Yuichi Endo Hiroki Uchida Masayuki Tominaga Ryoki Okunaga Seiichiro Kai Seigo Kitano |
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Institution: | (1) Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Oita 879-5593, Japan |
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Abstract: | Adenomyomatous hyperplasia is most commonly found in the stomach, gallbladder, duodenum, and jejunum, while it is rarely found
in the extrahepatic bile duct. A 62-year-old woman was referred to our institution with a diagnosis of common bile duct (CBD)
stenosis which had been detected by endoscopic retrograde cholangiopancreatography (ERCP). Abdominal computed tomography with
contrast medium revealed a thickening of the wall of the lower CBD, and this lesion was weakly enhanced by contrast medium
in the arterial phase. ERCP revealed a 15-mm-long stenosis of the lower CBD, but no malignant cells were detected by either
bile cytology or brush cytology. Because CBD cancer could not be ruled out, pylorus-preserving pancreatoduodenectomy was performed.
Histopathologically, multiple hyperplastic glands without cellular atypia were present in the lower CBD wall. An immunohistochemical
study showed fibroblasts with positive staining for α-smooth muscle actin surrounding the glands. The lesion was diagnosed
to be adenomyomatous hyperplasia of the CBD. When a diagnosis of adenomyomatous hyperplasia of the CBD is difficult to make
both preoperatively and intraoperatively, then a radical surgical procedure, such as a pancreatoduodenectomy, may be an effective
treatment alternative. |
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Keywords: | Adenomyomatous hyperplasia Bile duct Papilla of Vater |
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