Abstract
Ciliated hepatic foregut cysts (CHFC) are rare cystic lesions of the liver composed of a ciliated pseudostratified columnar epithelium with mucous cells, connective tissue, and smooth muscles bundles. We report the first case of CHFC with extensive squamous metaplasia without dysplasia or carcinoma. A unilocular, avascular, hypoechoic 60-mm liver lesion located in segment IV was detected by ultrasonography in a 31-year-old woman. The cyst was surgically removed and was lined mainly by a regular squamous epithelium without keratin formation. After extensive sampling, a ciliated pseudostratified columnar epithelium with some alcian blue-positive goblet cells was identified. The lesion was totally examined and there was no epithelial dysplasia or carcinoma. Squamous epithelium is very rare in hepatic foregut cysts and may degenerate into squamous carcinoma. Squamous epithelium is also described in biliary cysts. When squamous epithelium is identified in a liver cyst, an extensive sampling is recommended to identify possible foci of squamous carcinoma and to classify more precisely the histological type of the lesion. Because some cases of squamous carcinoma have been described in CHFC, surgical removal of the lesion may be more appropriate than close follow-up or sclerosing therapy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chatelain D, Chailley-Heu B, Terris B, Molas G, Le Cae A, Vilgrain V, Belghiti J, Degott C, Flejou JF (2000) The ciliated hepatic foregut cyst, an unusual bronchiolar foregut malformation: a histological, histochemical, and immunohistochemical study of 7 cases. Hum Pathol 31:241–246
de Lajarte-Thirouard AS, Rioux-Leclercq N, Boudjema K, Gandon Y, Ramee MP, Turlin B (2002) Squamous cell carcinoma arising in a hepatic forgut cyst. Pathol Res Pract 198:697–700
Furlanetto A, Dei Tos AP (2002) Squamous cell carcinoma arising in a ciliated hepatic foregut cyst. Virchows Arch 441:296–298
Hornstein A, Batts KP, Linz LJ, Chang CD, Galvanek EG, Bardawil RG (1996) Fine needle aspiration diagnosis of ciliated hepatic foregut cysts: a report of three cases. Acta Cytol 40:576–580
Kajiya Y, Nakajo M, Ichinari N, Yamazumi K, Otuji T, Tanaka T (1997) Retroperitoneal foregut cyst. Abdom Imaging 22:111–113
Koletsa T, Tzioufa V, Michalopoulos A, Apostolidis S, Papadopoulos B, Hytiroglou P (2005) Ciliated hepatic foregut cyst communicating with the gallbladder. Virchows Arch 446:200–201
Konishi E, Nakashima Y, Iwasaki T (2003) Immunohistochemical analysis of retroperitoneal mullerian cyst. Hum Pathol 34:194–198
Munshi IA, Parra-Davila E, Casillas VJ, Sleeman D, Levi JU (1998) Ciliated foregut cyst of the pancreas. HPB Surg 11:117–119
Pliskin A, Cualing H, Stenger RJ (1992) Primary squamous cell carcinoma originating in congenital cysts of the liver. Report of a case and review of the literature. Arch Pathol Lab Med 116:105–107
Schullinger JN, Wigger HJ, Price JB, Benson M, Harris RC (1983) Epidermoid cysts of the liver. J Pediatr Surg 18:240–242
Vick DJ, Goodman ZD, Deavers MT, Cain J, Ishak KG (1999) Ciliated hepatic foregut cyst: a study of six cases and review of the literature. Am J Surg Pathol 23:671–677
Vick DJ, Goodman ZD, Ishak KG (1999) Squamous cell carcinoma arising in a ciliated hepatic foregut cyst. Arch Pathol Lab Med 123:1115–1117
Wheeler DA, Edmondson HA (1984) Ciliated hepatic foregut cyst. Am J Surg Pathol 8:467–470
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ben Mena, N., Zalinski, S., Svrcek, M. et al. Ciliated hepatic foregut cyst with extensive squamous metaplasia: report of a case. Virchows Arch 449, 730–733 (2006). https://doi.org/10.1007/s00428-006-0320-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00428-006-0320-4