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Benign Beale Gland Hyperplasia Mimicking Malignant Biliary Obstruction
Durairaj Segamalai1, Anand Lakshmanan2, Abdul Rehman Abdul Jameel1
1Postgraduate, Institute of surgical gastroenterology, Madras Medical College, Chennai, Tamil Nadu, India.
Journal of Clinical and Diagnostic Research : JCDR
|September 13, 2017
Summary
Benign Intramural Beale gland hyperplasia can cause distal Common Bile Duct obstruction, mimicking cancer. This rare condition presents as painless jaundice but is distinct from bile duct adenocarcinoma.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Pathology
Background:
- Extrahepatic bile duct obstruction is frequently caused by malignant pathologies, typically presenting as painless, progressive jaundice.
- Peribiliary glands (Beale Glands) are normally found within the bile duct walls and surrounding connective tissue.
Observation:
- A case of distal Common Bile Duct (CBD) obstruction was observed.
- The obstruction was caused by Benign Intramural Beale gland hyperplasia, which mimicked a periampullary carcinoma on initial presentation.
Findings:
- Beale Gland hyperplasia is an uncommon condition, rarely presenting as a macroscopic or imaging-visible finding.
- This entity is differentiated from well-differentiated bile duct adenocarcinoma by preserved lobular architecture, absence of cytological atypia, and lack of perineural invasion.
Implications:
- This case highlights a rare cause of bile duct obstruction that can be mistaken for malignancy.
- Accurate distinction is crucial for appropriate patient management and avoiding unnecessary oncological treatment.
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