[1576] Hepatic Biliary Cystadenoma: A Clinico-Pathological and Immunohistochemical Study.

Jie Ouyang, David Cannan, Stephen C Ward, Swan N Thung, M Isabel Fiel. The Mount Sinai Medical Center, New York, NY

Background: Biliary cystadenoma is a rare lesion. This is a retrospective study aimed at characterizing the clinical and histological features of liver cystadenomas and their mucin (MUC) profile by immunohistochemistry.
Design: The pathology database from 1995-2010 was searched and clinical data was gathered from medical records. Detailed histological assessment was performed; when available, immunostains for estrogen and progesterone receptors (ER/PR) were evaluated. Immunostaining using antibodies to MUC2, MUC6, MUC5AC were performed.
Results: In total, 22 cases of cystadenoma were found and 12 were available for review. Eleven of 12 were female, mean age 45 years (range:33-62). Six of 12 were located in the left lobe, 3/12 in the right lobe, and 3/12 in the porta hepatis. The tumors were all multilocular, ranging from 1-29 cm in size (mean 8 cm). A single layer of lining epithelium was present throughout; 7/12 were of the mixed gastric foveolar (mucinous) and pancreatobiliary type having focal intestinal metaplasia in one case, 4/12 was pure pancreatobiliary type. One case (male) was exclusively lined by gastric foveolar type epithelium. Ovarian type stroma was present in all cases. No epithelial dysplasia or carcinoma was found in any case. ER/PR expression was seen in 4 of 4 cases. The period of follow-up ranged from 2 months to 15 years; only 1 of 12 had recurrent disease, 3 years after the initial resection. The MUC immunostaining results and staining expression of other pancreatobiliary neoplasms are presented in Table 1.

Mucin profile in liver cystadenoma and adjacent bile duct
 MUC2MUC5ACMUC6
Intrahepatic cystadenoma8.3%50%42%
Adjacent bile duct epithelium0%0%58.3%
Cholangiocarcinoma*23.5%66.1%14.1%
Pancreatic invasive ductal carcinoma*0%92%56%
Intraductal papillary mucinous neoplasm,pancreas*96%92%37%
Mucinous cystic neoplasm of pancreas*0%37.5-100%few cells
Normal pancreatic ductal epithelium*0%0%67%
* From medical literature


Conclusions: Liver cystadenomas are clinically and histologically similar to cystadenomas from other organs; the majority occurs in females and ovarian type stroma is typically present. Liver cystadenomas are often lined by mixed type epithelium and only infrequently with pure pancreatobiliary or gastric foveolar lining. ER/PR expression is universally expressed in the ovarian stroma. Liver cystadenomas are more common in the left lobe. Liver cystadenomas may demonstrate either a predominant MUC5AC or MUC6 expression pattern. Normal bile ducts have similar MUC expression as normal pancreatic ducts.
Category: Liver & Pancreas

Tuesday, March 1, 2011 1:00 PM

Poster Session IV # 196, Tuesday Afternoon

 

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