Surgery Today

, Volume 38, Issue 1, pp 85–89 | Cite as

Adenomyomatous Hyperplasia of the Common Bile Duct: Report of a Case

  • Kentaro Iwaki
  • Kohei Shibata
  • Masayuki Ohta
  • Yuichi Endo
  • Hiroki Uchida
  • Masayuki Tominaga
  • Ryoki Okunaga
  • Seiichiro Kai
  • Seigo Kitano
Case Reports

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.

Key words

Adenomyomatous hyperplasia Bile duct Papilla of Vater 

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Copyright information

© Springer-Verlag Tokyo 2008

Authors and Affiliations

  • Kentaro Iwaki
    • 1
  • Kohei Shibata
    • 1
  • Masayuki Ohta
    • 1
  • Yuichi Endo
    • 1
  • Hiroki Uchida
    • 1
  • Masayuki Tominaga
    • 1
  • Ryoki Okunaga
    • 1
  • Seiichiro Kai
    • 1
  • Seigo Kitano
    • 1
  1. 1.Department of Surgery IOita University Faculty of MedicineOitaJapan

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