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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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Published on: February 28, 2025

A case of a choledochal cyst associated with a lymphatic infiltration of a hyperplastic gallbladder epithelium

Yutaka Hirayama1, Masayuki Kubota, Go Hasegawa

  • 1Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata 951-8510, Japan. you4141@aol.com

Journal of Pediatric Surgery
|April 14, 2009
PubMed

Insights

A congenital choledochal cyst in a child showed gallbladder epithelial atypism with lymphatic displacement. This finding, though concerning, was not indicative of cancer, highlighting the importance of careful histologic evaluation.

Area of Science:

  • Pediatric Surgery
  • Surgical Pathology
  • Gastroenterology

Background:

  • Congenital choledochal cysts (CCCs) are rare biliary tract malformations.
  • Todani type IV-A CCCs involve intrahepatic and extrahepatic bile ducts.
  • Gallbladder abnormalities can occur secondary to CCCs.

Observation:

  • A 4-year-old girl with a Todani IV-A CCC underwent resection of the common bile duct and gallbladder.
  • Histology revealed gallbladder hyperplastic changes with cribriform proliferation.
  • Clusters resembling tumor cells were noted within lymphatic vessels.

Findings:

  • Despite lymphatic involvement, no definitive neoplastic changes were found in the gallbladder or bile duct.
  • The final diagnosis was epithelial atypism with reactive hypertrophy.
  • Lymphatic displacement was considered an incidental finding within a hyperplastic process.

Implications:

  • This case suggests that lymphatic infiltration of hyperplastic gallbladder epithelium may not always signify malignancy.
  • Careful histopathological assessment is crucial to differentiate reactive changes from true carcinogenesis.
  • Long-term follow-up is essential to confirm the absence of tumor recurrence.

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