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Ciliated hepatic foregut cyst mimicking neoplasm
M L Wu1, M M Abecassis, M S Rao
1Department of Pathology, Northwestern Memorial Hospital, Chicago, Illinois 60611, USA.
The American Journal of Gastroenterology
|November 20, 1998
Summary
Ciliated hepatic foregut cysts can mimic tumors due to large size and high carbohydrate antigen 19-9 (CA 19-9) levels. Histology confirms these cysts, even with elevated CA 19-9, are not neoplastic.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Pathology
Background:
- Ciliated hepatic foregut cysts are rare congenital anomalies.
- Clinical presentation can sometimes mimic neoplastic lesions, leading to diagnostic challenges.
Observation:
- A large, bilocular cyst was clinically suspected to be neoplastic.
- Elevated serum levels of carbohydrate antigen 19-9 (CA 19-9) were noted.
- Histological examination revealed characteristic features of a ciliated hepatic foregut cyst.
Findings:
- The cyst wall exhibited pseudopapillae lined by ciliated stratified columnar epithelium with goblet cells.
- Underlying smooth muscle was present in the cyst wall.
- The epithelial lining showed strong immunoreactivity for CA 19-9.
Implications:
- Large size and multilocularity do not exclude a diagnosis of ciliated hepatic foregut cyst.
- Elevated CA 19-9 levels can be associated with benign ciliated hepatic foregut cysts.
- This finding aids in accurate histopathological diagnosis and avoids unnecessary aggressive treatment.