Biliary cystadenoma

From Dog
Gross appearance of biliary cystadenoma in a dog[1]

Biliary cystadenoma are a benign neoplasm of the gall bladder of older dogs.

These tumors arise from the biliary epithelium and frequently occur in the intrahepatic bile duct[2][3], sometimes induced by pancreatic juice reflux[4], carcinogens[5] or hepatic parasites.

Clinical signs associated with these tumors are usually non-specific or absent and diagnosis is made from diagnostic imaging and histopathologic examination.

Serum biochemical examination usually reveals elevated hepatobiliary enzymes (ALT, ALP, GGT and bile acids). Rarely, invasion or communication of bile ducts with biliary cystadenoma may result in pancreatitis[6].

Ultrasonography usually shows varying degrees of gall bladder enlargement with a visible large septated, multiloculated cystic mass in the right caudate liver lobe.

A fine-needle aspirate should be performed and fluid contents culture for microbial presence.

Histological features of biliary cystadenoma consist of a multilocular cyst lined with cuboidal to columnar epithelial cells and cellular stroma.

Diagnosis of biliary cystadenoma can be challenging and is one of exclusion because other cystic lesions, such as hepatic simple cyst, have a similar appearance.

A differential diagnosis would include bile duct carcinoma, cholecystitis, liver flukes, hepatic adenoma, hepatic lymphoma.

Treatment usually requires complete surgical excision of biliary cystadenoma via lobectomy and is usually curative[7].

References

  1. Moon SJ et al (2011) Biliary cystadenoma in a Maltese dog: clinical and diagnostic findings. J Vet Med Sci 73(12):1677-1679
  2. Hernandez, MA et all (2009) Biliary cystadenoma. World J Gastroenterol 15:3573–3575
  3. Kim, HG (2006) Biliary cystic neoplasm: biliary cystadenoma and biliary cystadenocarcinoma. Korean J Gastroenterol 47:5–14
  4. Miyano T et al (1989) Adenoma and stone formation of the biliary tract in puppies that had choledochopancreatic anastomosis. J Pediatr Surg 24(6):539-542
  5. Hahn FF et al (1996) Hepatic neoplasms from internally deposited 144CeCl3. Toxicol Pathol 24(3):281-289
  6. Teoh, AY et al (2006) Biliary cystadenoma and other complicated cystic lesions of the liver: diagnostic and therapeutic challenges. World J Surg 30:1560–1566
  7. Center, SA (2009) Diseases of the gallbladder and biliary tree. Vet Clin North Am Small Anim Pract 39:543–598