Biliary adenofibroma of the liver: report of a case and review of the literature

Our plain-English summary of Biliary adenofibroma of the liver: report of a case and review of the literature, by A. Gurrera, R. Alaggio, G. Leone, et al (Pathology Research International, 2010).

The study

• Authors: A. Gurrera, R. Alaggio, G. Leone, G. Aprile, G. Magro
• Journal: Pathology Research International
• Published: 2010;2010:504584
• Type of article: Case report
• Cited by: 28 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

We herein report the clinicopathologic features of a rare case of biliary adenofibroma (BAF) of the liver in a 79-year-old man. Grossly, tumour presented as a well-circumscribed, 5.5-cm mass with a solid and microcystic appearance. Histological examination was typical of biliary adenofibroma, showing a proliferation of variable-sized tubulocystic structures embedded in a moderately cellular fibrous stroma. Immunohistochemistry, revealing immunoreactivity of the epithelial component to cytokeratins 7 and 19, was consistent with a bile duct origin. Notably, the stromal cells had a myofibroblastic profile, showing a diffuse and strong expression of vimentin and α-smooth muscle actin. Differential diagnosis with Von Meyenburg complex, biliary adenoma, biliary cistadenoma, congenital biliary cystsy, and hepatic benign cystic mesothelioma is provided. The occasionally reported expression of p53 in biliary adenofibroma has suggested that this tumour could represent a premalignant lesion. The absence of both cytological atypia and p53 immunoreactivity in our case confirms that BAF is a benign tumour with an indolent clinical behaviour. However, a careful histological examination of BAF is mandatory because malignant transformation of the epithelial component has been documented in two cases.

In plain English

This article was a case report, with a brief review of the medical literature, on biliary adenofibroma, a rare liver tumour that the authors described as being of bile duct origin. It did not concern asbestos. The patient, a 79-year-old man with vague abdominal pain, had a solid 5.5 cm mass in the right lobe of the liver, and part of the liver was surgically removed. Under the microscope the tumour consisted of tubes and cysts lined by bile duct-type cells set in fibrous tissue. There was no necrosis, mitoses or nuclear pleomorphism. Staining for p53 was negative and the Ki-67 proliferation index was low, at 1%. The patient was well with no recurrence after 7 years of follow-up. The authors noted that only six earlier cases had been reported, and two of those showed malignant change. Benign cystic mesothelioma of the liver came up only as a condition to distinguish from this tumour. The authors concluded that the tumour should be regarded as benign, but that any such tumour should be carefully examined to rule out malignancy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report with review of the literature
• Who was studied: One patient: a 79-year-old man with a liver mass (Italy, authors from Catania and Padova)
• Main results:
  • Imaging showed a solid 5.5 cm mass in the right lobe of the liver in this patient
  • In this patient's tumour, necrosis, mitoses and nuclear pleomorphism were absent
  • In this patient's tumour, the epithelial component was negative for p53, calretinin, HBME-1 and cytokeratins 5/6, among other markers
  • In this patient's tumour, the Ki-67 proliferation index was low (1%)
  • In this patient's tumour, the stromal cells stained for vimentin and alpha-smooth muscle actin and were regarded as myofibroblastic
  • The patient had no recurrence after 7 years of follow-up
  • Literature review (other studies, not this case): only six earlier cases had been reported, and two of them underwent epithelial malignant transformation
• The authors' conclusion: The authors concluded that, given the absent p53 staining in their case, biliary adenofibroma should be regarded as a benign tumour, but that any such tumour should be carefully evaluated to rule out malignancy

Topics

Medical terms in this study, explained in our Lexicon: Immunohistochemistry, Differential Diagnosis, Mesothelioma, Malignant Transformation.

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