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

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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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Authors and Affiliations

  1. Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Oita, 879-5593, Japan

    Kentaro Iwaki, Kohei Shibata, Masayuki Ohta, Yuichi Endo, Hiroki Uchida, Masayuki Tominaga, Ryoki Okunaga, Seiichiro Kai & Seigo Kitano

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  1. Kentaro Iwaki
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  2. Kohei Shibata
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  3. Masayuki Ohta
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  4. Yuichi Endo
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  5. Hiroki Uchida
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  6. Masayuki Tominaga
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  7. Ryoki Okunaga
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  8. Seiichiro Kai
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  9. Seigo Kitano
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Iwaki, K., Shibata, K., Ohta, M. et al. Adenomyomatous Hyperplasia of the Common Bile Duct: Report of a Case. Surg Today 38, 85–89 (2008). https://doi.org/10.1007/s00595-007-3558-9

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  • DOI: https://doi.org/10.1007/s00595-007-3558-9

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