Clinical pathological and imaging diagnosis of hepatic biliary cystadenoma and cystadenocarcinoma

Objective To explore the clinical pathological and imaging findings of hepatic biliary cystadenoma and cystadenocarcinoma.Methods The clinical,pathological and imaging findings of 11 patients with hepatic biliary cystadenoma or cystadenocarcinoma confirmed with operation and pathology were analyzed retrospectively.Results Among 11 patients,there were 6 biliary cystadenoma and 5 cystadenocarcinoma.Upper abdominal discomfort and distending pain occurred in 4 patients.Patients with cystadenocarcinoma showed positive CEA,CK7 and CK19,while patients with cystadenocarcinoma stromal cells showed positive Vim,Actin and PR.Lesions located at the left lobe in 9 patients,multilocular cystic or cystic-solid tumors were found in 8 patients and upstream bile duct dilatation in 7 patients.As for biliary cystadenoma,5 patients had regular borders,thin septum,without or with small mural nodules within the lesions.There was no vascular signal with CDFI in biliary cystadenoma patients,nor enhancement in CT and MR.As for biliary cystadenocarcinoma,lesions in 4 patients had irregular borders,thick septum,large mural nodules within the lesion,some or none vascular signal in CDFI.Heterogeneous enhancement could be observed in CT and MR.Conclusion Features including hepatic multilocular cystic or cystic-solid lesion,mural nodules within the lesion,upstream bile duct dilatation,etc.are helpful to the diagnosis of hepatic biliary cystadenoma and cystadenocarcinoma.