Cytologic diagnosis of hepatobiliary cystadenoma with mesenchymal stroma during intraoperative consultation: a case report

Acta Cytol. 2010 Sep-Oct;54(5 Suppl):928-32.


Background: Hepatobiliary cystadenoma with mesenchymal stroma (HCMS) is a rare cystic tumor characterized by a layer of mucinous cuboidal to columnar epithelium situated on top of a basement membrane resting on an ovarian-like stroma. Cytologic features of this entity have not been extensively studied. We present a case of HCMS with emphasis on cytologic material obtained at the time of intraoperative consultation (IOC).

Case: A 51-year-old woman had partial resection of a liver cyst. Seven months later she sought further medical attention and presented for surgical reevaluation and reexcision of the same lesion. Initial computed tomography revealed a multiloculated liver cyst. Five months after reexcision the lesion recurred and was again excised. During IOC, scrape cytology revealed both biliary epithelial and mesenchymal stromal cells in a cystic background. Permanent sections showed histologic features of HCMS. To the best of our knowledge, this is the first cytologic description of such a neoplasm to include both epithelial and mesenchymal stromal elements.

Conclusion: The use of scrape cytology during IOC can be a fast and effective way of identifying both the epithelium and mesenchymal stroma when HCMS is in the differential diagnosis of a cystic liver lesion.

Publication types

  • Case Reports

MeSH terms

  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / pathology
  • Bile Ducts / pathology
  • Cystadenoma / diagnosis*
  • Cystadenoma / pathology*
  • Cysts / pathology
  • Epithelial Cells / pathology
  • Female
  • Humans
  • Intraoperative Care*
  • Liver / pathology
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / pathology
  • Mesoderm / pathology*
  • Middle Aged
  • Referral and Consultation*
  • Stromal Cells / pathology