Clin Mol Hepatol.  2015 Dec;21(4):393-397. 10.3350/cmh.2015.21.4.393.

Intrahepatic bile duct adenoma in a patient with chronic hepatitis B accompanied by elevation of alpha-fetoprotein

• Ahn JM
• Paik YH
• Lee JH
• Cho JY
• Sohn W
• Gwak GY
• Choi MS
• Lee JH
• Koh KC
• Paik SW
• Yoo BC

• KMID: 2359822
• DOI: http://doi.org/10.3350/cmh.2015.21.4.393

Abstract

A 51-year-old male patient with chronic hepatitis B was referred to our hospital due to a 1-cm liver nodule on ultrasonography. Alpha-fetoprotein (AFP) was slightly elevated. The nodule showed prolonged enhancement on dynamic liver magnetic resonance imaging and appeared as a hyperintensity on both diffusion-weighted and T2-weighted imaging. The nodule was followed up because it was small and typical findings of hepatocellular carcinoma (HCC) were not observed in the dynamic imaging investigations. However, liver contrast-enhanced ultrasonography performed 1 month later showed enhancement during the arterial phase and definite washout during the delayed phase. Also, AFP had increased to over 200 ng/mL even though AST and ALT were decreased after administering an antiviral agent. He was presumptively diagnosed as HCC and underwent liver segmentectomy. Microscopy findings of the specimen indicated bile duct adenoma. After resection, the follow-up AFP had decreased to within the normal range. This patient represents a case of bile duct adenoma with AFP elevation mimicking HCC on contrast-enhanced ultrasonography.

Keyword

Adenoma; Bile duct; Hepatitis B; Alpha-fetoproteins; Ultrasonography

MeSH Terms

Bile Duct Neoplasms/*complications/*diagnosis/pathology
*Bile Ducts, Intrahepatic
Hepatitis B, Chronic/*complications/*diagnosis/pathology
Humans
Liver/pathology/ultrasonography
Magnetic Resonance Imaging
Male
Middle Aged
Tomography, X-Ray Computed
alpha-Fetoproteins/*metabolism
alpha-Fetoproteins