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Hepatic cysts reappraisal of the classification, terminology, differential diagnosis, and clinicopathologic characteristics in 258 cases

dc.contributor.coauthorQuigley, Brian
dc.contributor.coauthorChoi, Hegyong
dc.contributor.coauthorBasturk, Olca
dc.contributor.coauthorAkkas, Gizem
dc.contributor.coauthorPehlivanoglu, Burcin
dc.contributor.coauthorMemis, Bahar
dc.contributor.coauthorJang, Kee-Taek
dc.contributor.coauthorErkan, Mert
dc.contributor.coauthorErkan, Burcu
dc.contributor.coauthorBalci, Serdar
dc.contributor.coauthorBagci, Pelin
dc.contributor.coauthorFarris, Alton B.
dc.contributor.coauthorKooby, David A.
dc.contributor.coauthorMartin, Diego
dc.contributor.coauthorKalb, Bobby
dc.contributor.coauthorMaithel, Shishir K.
dc.contributor.coauthorSarmiento, Juan
dc.contributor.coauthorReid, Michelle D.
dc.contributor.departmentKUTTAM (Koç University Research Center for Translational Medicine)
dc.contributor.departmentKUH (Koç University Hospital)
dc.contributor.departmentSchool of Medicine
dc.contributor.kuauthorAdsay, Nazmi Volkan
dc.contributor.kuauthorArmutlu, Ayşe
dc.contributor.kuauthorErkan, Burcu
dc.contributor.kuauthorSaka, Burcu
dc.contributor.schoolcollegeinstituteKUH (KOÇ UNIVERSITY HOSPITAL)
dc.contributor.schoolcollegeinstituteResearch Center
dc.contributor.schoolcollegeinstituteSCHOOL OF MEDICINE
dc.date.accessioned2024-11-09T23:06:49Z
dc.date.issued2022
dc.description.abstractThe literature on liver cysts is highly conflicting, mostly owing to definitional variations. Two hundred and fifty-eight >= 1 cm cysts evaluated pathologically using updated criteria were classifiable as: I. Ductal plate malformation related (63%); that is, cystic bile duct hamartoma or not otherwise specified-type benign biliary cyst (35 with polycystic liver disease). These were female predominant (F/M=2.4), large (10 cm), often multifocal with degenerative/inflammatory changes and frequently misclassified as "hepatobiliary cystadenoma." II. Neoplastic (13%); 27 (10.5%) had ovarian-type stroma (OTS) and qualified as mucinous cystic neoplasm (MCN) per World Health Organization (WHO). These were female, solitary, mean age 52, mean size 11 cm, and 2 were associated with carcinoma (1 in situ and 1 microinvasive). There were 3 intraductal papillary neoplasms, 1 intraductal oncocytic papillary neoplasm, 1 cystic cholangiocarcinoma, and 2 cystic metastasis. III. Infectious/inflammatory (12%). These included 23 hydatid cysts (including 2 Echinococcus alveolaris both misdiagnosed preoperatively as cancer), nonspecific inflammatory cysts (abscesses, inflammatory cysts: 3.4%). IV. Congenital (7%). Mostly small (<3 cm); choledochal cyst (5%), foregut cyst (2%). V. Miscellaneous (4%). In conclusion, hepatic cysts occur predominantly in women (3/1), are mostly (90%) non-neoplastic, and seldom (<2%) malignant. Cystic bile duct hamartomas and their relative not otherwise specified-type benign biliary cysts are frequently multifocal and often misdiagnosed as "cystadenoma/carcinoma." Defined by OTS, MCNs (the true "hepatobiliary cystadenoma/carcinoma") are solitary, constitute only 10.5% of hepatic cysts, and have a significantly different profile than the impression in the literature in that essentially all are perimenopausal females, and rarely associated with carcinoma (7%). Since MCNs can only be diagnosed by demonstration of OTS through complete microscopic examination, it is advisable to avoid the term "cystadenoma/cystadenocarcinoma" solely based on radiologic examination, and the following simplified terminology would be preferable in preoperative evaluation to avoid conflicts with the final pathologic diagnosis: (1) noncomplex (favor benign), (2) complex (in 3 subsets, as favor benign, cannot rule out malignancy, or favor malignancy), (3) malignant features.
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.issue9
dc.description.openaccessNO
dc.description.publisherscopeInternational
dc.description.sponsoredbyTubitakEuN/A
dc.description.volume46
dc.identifier.doi10.1097/PAS.0000000000001930
dc.identifier.eissn1532-0979
dc.identifier.issn0147-5185
dc.identifier.quartileQ1
dc.identifier.scopus2-s2.0-85136496998
dc.identifier.urihttps://doi.org/10.1097/PAS.0000000000001930
dc.identifier.urihttps://hdl.handle.net/20.500.14288/9043
dc.identifier.wos840881200005
dc.keywordsHepatic cysts
dc.keywordsLiver cysts
dc.keywordsBiliary cystadenoma
dc.keywordsBiliary cystadenocarcinoma
dc.keywordsNeoplasia
dc.language.isoeng
dc.publisherLippincott Williams and Wilkins (LWW)
dc.relation.ispartofAmerican Journal of Surgical Pathology
dc.subjectPathology
dc.subjectSurgery
dc.titleHepatic cysts reappraisal of the classification, terminology, differential diagnosis, and clinicopathologic characteristics in 258 cases
dc.typeJournal Article
dspace.entity.typePublication
local.contributor.kuauthorArmutlu, Ayşe
local.contributor.kuauthorErkan, Burcu
local.contributor.kuauthorSaka, Burcu
local.contributor.kuauthorAdsay, Nazmi Volkan
local.publication.orgunit1SCHOOL OF MEDICINE
local.publication.orgunit1Research Center
local.publication.orgunit1KUH (KOÇ UNIVERSITY HOSPITAL)
local.publication.orgunit2KUTTAM (Koç University Research Center for Translational Medicine)
local.publication.orgunit2KUH (Koç University Hospital)
local.publication.orgunit2School of Medicine
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