Peribiliary glands pathology in a large series of end-stage alcohol-related liver disease
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ORIGINAL ARTICLE
Peribiliary glands pathology in a large series of end-stage alcohol-related liver disease Federica Pedica 1
&
Nigel Heaton 2 & Alberto Quaglia 2,3
Received: 16 April 2020 / Revised: 18 May 2020 / Accepted: 20 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract The peribiliary glands are intramural or extramural structures with multiple functions related to bile secretion. The peribiliary glands can develop cystic alterations in several conditions, such as alcohol addiction. Peribiliary cysts can enlarge till being radiologically visible and mimic cancer. We studied 217 consecutive explanted livers for end-stage alcohol-related liver disease from the Pathology Unit of the Liver Unit at the King's College Hospital in Denmark Hill, with particular focus on peribiliary glands. Our cohort consisted of 31 females and 186 males, with a median age of 51 and of 56 years respectively. 92,2% had established cirrhosis, 73,3% had only alcohol-induced liver disease, whilst 26,7% had other co-morbidities. We found a mild ectasia of the peribiliary glands ( = 2 mm) in 22,6% of cases. The diameter of the peribiliary glands varied from 1 mm to 8 mm. Inflammation of the peribiliary glands was found in the majority of cases with dilatation (p value = 0,000). 4,6% of the peribiliary cysts had low-grade intraductal papillary neoplasm of the bile ducts confined to the peribiliary glands. Pancreatic heterotopia was found in 10,6% and associated with the presence of ectasia. Our findings fit with what is reported in literature, such as the alcohol-induced damage at the peribiliary glands. Moreover these results underline the possible role of peribiliary glands in the development of the intraductal papillary neoplasm of the bile ducts, the biliary counterpart of the branch type intraductal mucinous neoplasm of the pancreas. Keywords Peribiliary glands . Peribiliary cysts . Intraductal papillary neoplasm of the bile duct . Alcohol-induced liver disease
Introduction The peribiliary cysts are dilatation of the peribiliary glands which are glandular structures mainly found in the peri-hilar region [1]. They can be intramural and communicating directly with the bile duct lumen or extramural mixed seromucinous draining into the lumen through some branching structures [2]. The peribiliary glands are both intrahepatic and extrahepatic and they have multiple functions that enhance bile secretion and composition [3].
This article is part of the Topical Collection on Quality in Pathology * Federica Pedica [email protected] 1
Pathology Unit, San Raffaele Scientific Institute, Milan, Italy
2
Institute of Liver Studies, King’s College Hospital, London, UK
3
Department of Cellular Pathology, Royal Free London, London, UK
They also contain pluripotent stem cells [4, 5] and can be associated with heterotopic pancreas in the hilar region [1]. Peribiliary glands cysts develop mainly in the hilar region [6] and can be of variable size, and ranging from 0,2 cm to 2 cm diameter, as described in one of
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