Abstract
A 59-year-old male was admitted to our hospital with jaundice. He had been diagnosed with alcoholic liver cirrhosis. Abdominal echogram revealed hilar cystic lesions up to 1.2 cm in diameter and tubular anechoic areas that were difficult to differentiate with dilation of the intrahepatic bile ducts. Computed tomography (CT) revealed hilar cystic lesions (panel A, arrow) and low-density areas along the large portal veins (panel A, arrow). Endoscopic retrograde cholangiopancreatography (ERCP) revealed meandering and abrupt cutoff of the left branches 5 cm from the bifurcation and the bile ducts showed a slight dilation after the narrowing (panel B, arrow). The common bile duct and pancreatic ducts were normal. Magnetic resonance cholangiopancreatography (MRCP) demonstrated bead-like cystic lesions along the biliary tree in the left lobe of the liver (panel C). Three months after admission, total bilirubin was over 40 mg/dl and the patient died of gastric mucosal bleeding. On autopsy, cystic lesions, up to 1.6 cm in diameter, were distributed along the portal tract predominantly in the left lobe of the liver (panel D, arrows). These cysts, which compressed the hilar bile ducts (panel D, arrow), were diagnosed by microscopic examination as peribiliary cysts. Peribiliary cysts are tiny retention cysts arising from the peribiliary glands in the large bile ducts and rarely obstruct the bile duct. Association with portal hypertension suggests that disturbed intrahepatic circulation causes the development of peribiliary cysts [[1]Nakanuma Y. Kurumaya H. Ohta G. Multiple cysts in the hepatic hilum and their pathogenesis: a suggestion of periductal gland origin.Virchows Arch A Pathol Anat Histopathol. 1984; 404: 341-350Crossref PubMed Scopus (100) Google Scholar]. There have been a few published reports showing characteristic images of peribiliary cysts on echogram, CT and MR [[2]Baron R.L. Campbell W.L. Dodd III, G.D. Peribiliary cysts associated with severe liver disease: imaging-pathological correlation.Am J Roentgenol. 1994; 162: 631-636Crossref PubMed Scopus (55) Google Scholar]. This case illustrates the distinctive information provided by ERCP and MRCP.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
