Multiple hepatic peribiliary cysts discovered incidentally at a medical examination

Abstract

We report a living patient with multiple hepatic peribiliary cysts. It was discovered incidentally during an ultrasonographic screening at a medical examination. Peribiliary cysts are multiple retention cysts of peribiliary glands. Although many autopsy cases of peribiliary cysts have been reported, there are few clinical cases of it in living patients. A CT performed immediately after drip-infusion cholangiography (DIC) was most useful for diagnosis in various imaging tests we performed.

Multiple hepatic peribiliary cysts with cirrhosis

“…This possibility is particularly interesting in the previously reported cases in patients without underlying circulatory disturbance. 10,11,13,14 In the present patients, case 2 and case 3 showed microscopic or macroscopic cystic dilatations of glands in other organs (e.g., ductular dilatation of esophageal glands, pancreatic cyst, enteritis cystica profunda), which may reflect the possibility of genetic susceptibility to cystic change in the ducts and tubules in these patients.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] This is a rare condition, and the incidence of this disease was 0.26% in all autopsy patients (1139 cases). 6 We experienced three cases of multiple peribiliary cysts in a relatively short period (from October 2001 to February 2002).…”

Hepatic Peribiliary Cysts with Rapidly Progressive Refractory Obstructive Jaundice and Esophageal Varices

“…MRCP is also useful for obtaining a diagnosis of HPBC (2,17,18); however, the connection between the biliary tract and cyst cannot be distinguished. On the other hand, drip infusion cholangiography-CT (DIC-CT) is reported to be useful for differentiating these cysts from obstructive bile ducts or dilated bile ducts, such as those seen in Caroli's disease (6,9,17,18).…”

The role of peribiliary cysts in biliary obstruction

“…Peribiliary cysts are often small and therefore may be mistaken for simple liver cysts. They are usually asymptomatic and are often found incidentally, 1,8 or during investigation in patients with cirrhosis 2,9 . The natural history of these cysts is not fully understood but is likely to be indolent in most cases.…”

“…They often occur at the confluence of the left and right hepatic ducts. These cystic lesions are usually asymptomatic and are therefore often found incidentally on imaging investigations 1,2 . Less commonly, peribiliary cysts may manifest by extrinsic biliary compression resulting in obstructive jaundice 3,4 .…”