A CASE OF BENIGN NON-PARASITIC SOLITARY HEPATIC CYST WITH OBSTRUCTIVE JAUNDICE

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  • 閉塞性黄疸を伴った良性非寄生虫性孤立性肝嚢胞の1例

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Abstract

A 70-year-old man was referred to the hospital because of an upper abdominal pain, fever and jaundice. Laboratory data showed mild jaundice (T-Bil 4.0mg/dl, D-Bil 3.1mg/dl) and high levels of bile duct enzymes, CRP and CA19-9 (340U/ml). CT revealed a cyst, 9×8cm in size, in the segment 4 of the liver, atrophy of the lateral segment and dilatation of the left intrahepatic bile duct. MRCP revealed the compression of the left hepatic duct by the cyst and a dilatation of the bile duct in the lateral segment. ERCP revealed no communication between the bile duct and cyst, and the left hepatic duct retracted downwards and obstructed by compression of the cyst. Portography via superior mesenteric arteriogram did not demonstrated the left portal branch. After improvement of jaundice and inflammation, a left hepatic lobectomy including the left caudate lobe was performed. The cyst was filled with 500cc of serous fluid, and its wall was smooth. The bile duct in the lateral segment was filled with biliary sludge. Histological examination showed that the cyst wall had single layer of cuboidal epithelium without any malignancy.

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