High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy Journal Article


Authors: Bickenbach, K. A.; Shia, J.; Klimstra, D. S.; DeMatteo, R. P.; Fong, Y.; Kingham, T. P.; Allen, P. J.; Jarnagin, W. R.; D'Angelica, M. I.
Article Title: High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy
Abstract: Background: A total of 750 000 cholecystectomies are performed annually in the USA. No data exist on patients with microscopic high-grade dysplasia at the cystic duct margin and the associated incidence of cholangiocarcinoma. Methods: Pathology reports for 1992-2010 were reviewed for patients with high-grade dysplasia of the cystic duct margin in the absence of invasive gallbladder cancer. Clinical data were obtained from chart review. Results: Five patients with high-grade dysplasia at the cystic duct margin without evidence of malignancy were identified. Radiologic imaging was abnormal in two patients. The cystic duct stump was abnormally dilated in both patients and one patient had an enlarged portacaval lymph node. All five patients underwent exploration and resection of either the cystic duct stump or the bile duct. Specimens in four of the patients showed no evidence of malignancy or dysplasia. One patient was found to have a node-positive adenocarcinoma of the cystic duct. Conclusions: High-grade dysplasia at the cystic duct margin without evidence of invasive gallbladder cancer is rare. Patients with this finding should undergo cross-sectional imaging and a diagnosis of an underlying cholangiocarcinoma should be considered, especially if imaging reveals any abnormalities. © 2011 International Hepato-Pancreato-Biliary Association.
Keywords: cholangiocarcinoma; dysplasia; cystic duct
Journal Title: HPB
Volume: 13
Issue: 12
ISSN: 1365-182X
Publisher: Elsevier Science, Inc.  
Date Published: 2011-12-01
Start Page: 865
End Page: 868
Language: English
DOI: 10.1111/j.1477-2574.2011.00388.x
PROVIDER: scopus
PUBMED: 22081921
PMCID: PMC3244625
DOI/URL:
Notes: --- - "Export Date: 9 December 2011" - "CODEN: HPBIF" - "Source: Scopus"
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MSK Authors
  1. Ronald P DeMatteo
    637 DeMatteo
  2. David S Klimstra
    978 Klimstra
  3. Jinru Shia
    720 Shia
  4. Peter Allen
    501 Allen
  5. William R Jarnagin
    905 Jarnagin
  6. Yuman Fong
    775 Fong
  7. T Peter Kingham
    612 Kingham