Smooth Muscle Distribution Patterns of Choledochal Cysts and Their Implications for Pathogenesis and Postoperative Complications
Abstract Objectives Histopathologic characteristics of choledochal cysts and their clinical implications have not been previously comprehensively studied. Methods Smooth muscle distribution patterns and other histologic findings (inflammation, metaplasia, dysplasia, and heterotopia) in 233 surgicall...
Gespeichert in:
| Veröffentlicht in: | American journal of clinical pathology 2020-06, Vol.153 (6), p.760-771 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 771 |
|---|---|
| container_issue | 6 |
| container_start_page | 760 |
| container_title | American journal of clinical pathology |
| container_volume | 153 |
| creator | Hwang, Hee Sang Kim, Mee-Jeong Lee, Seung-Soo Lee, Jae Hoon Song, Ki Byung Kim, Hyoung Jung Hwang, Shin Lee, Sung Koo Kim, Myung-Hwan Hong, Seung-Mo |
| description | Abstract
Objectives
Histopathologic characteristics of choledochal cysts and their clinical implications have not been previously comprehensively studied.
Methods
Smooth muscle distribution patterns and other histologic findings (inflammation, metaplasia, dysplasia, and heterotopia) in 233 surgically resected choledochal cysts were evaluated.
Results
Mean patient age was 23.3 ± 19.8 years, with male:female ratio of 0.3. Most cases were Todani type I (175 cases, 75.1%) or IVa (56 cases, 24.1%). Choledochal cysts with thin scattered/no muscle fiber (175 cases, 75.1%) were the predominant pattern and were associated with more frequent postoperative biliary stricture (P = .031), less frequent pyloric metaplasia (P = .016), and mucosal smooth muscle aggregates (P |
| doi_str_mv | 10.1093/ajcp/aqaa002 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2350341857</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A645246757</galeid><oup_id>10.1093/ajcp/aqaa002</oup_id><sourcerecordid>A645246757</sourcerecordid><originalsourceid>FETCH-LOGICAL-c456t-d31cd12e21e0e84c09b7df26abb579bec980201c3a4cb7122788fa19075c567b3</originalsourceid><addsrcrecordid>eNp9kdFr1TAUh4M43HX65rMEfNAHuyVp0rSPo043mDhwPoc0PV1zaZsuSYW9-acv9V43FZE8BA7f9-Mcfgi9ouSYkio_0Vszn-hbrQlhT9CGVjzPpGTsKdqQNMoqKvND9DyELSGUlYQ_Q4c5I6vLNujH19G52OPPSzAD4A82RG-bJVo34SsdI_gpYNfhuncDtM70esD1XYgB66nF1z1Yjy_GebBGr07AnfOr2LsbmCDYHXflQnQz-MR8B1y734QX6KDTQ4CX-_8Ifft4dl2fZ5dfPl3Up5eZ4aKIWZtT01IGjAKBkhtSNbLtWKGbRsiqAVOVJB1lcs1NIyljsiw7TSsihRGFbPIj9G6XO3t3u0CIarTBwDDoCdwSFMsFyTkthUzom7_QrVv8lLZTjDMhJC0of6Ru9ADKTp2LXps1VJ0WXDBeyJ9Zx_-g0mthtMZN0Nk0_0N4vxOMdyF46NTs7aj9naJEraWptXC1Lzzhr_e7Ls0I7QP8q-EEvN0Bbpn_H3UPZty1GQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2425571614</pqid></control><display><type>article</type><title>Smooth Muscle Distribution Patterns of Choledochal Cysts and Their Implications for Pathogenesis and Postoperative Complications</title><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Hwang, Hee Sang ; Kim, Mee-Jeong ; Lee, Seung-Soo ; Lee, Jae Hoon ; Song, Ki Byung ; Kim, Hyoung Jung ; Hwang, Shin ; Lee, Sung Koo ; Kim, Myung-Hwan ; Hong, Seung-Mo</creator><creatorcontrib>Hwang, Hee Sang ; Kim, Mee-Jeong ; Lee, Seung-Soo ; Lee, Jae Hoon ; Song, Ki Byung ; Kim, Hyoung Jung ; Hwang, Shin ; Lee, Sung Koo ; Kim, Myung-Hwan ; Hong, Seung-Mo</creatorcontrib><description>Abstract
Objectives
Histopathologic characteristics of choledochal cysts and their clinical implications have not been previously comprehensively studied.
Methods
Smooth muscle distribution patterns and other histologic findings (inflammation, metaplasia, dysplasia, and heterotopia) in 233 surgically resected choledochal cysts were evaluated.
Results
Mean patient age was 23.3 ± 19.8 years, with male:female ratio of 0.3. Most cases were Todani type I (175 cases, 75.1%) or IVa (56 cases, 24.1%). Choledochal cysts with thin scattered/no muscle fiber (175 cases, 75.1%) were the predominant pattern and were associated with more frequent postoperative biliary stricture (P = .031), less frequent pyloric metaplasia (P = .016), and mucosal smooth muscle aggregates (P < .001) compared to cysts with thick muscle bundles. Severe chronic cholangitis (P = .049), pyloric metaplasia (P = .019), mucosal smooth muscle aggregates (P < .001), biliary intraepithelial neoplasia (P = .021), and associated bile duct (P = .021) and gallbladder carcinomas (P = .03) were more common in adults (age >20 years vs ≤20 years), suggesting that chronic irritation in association with developmental anomalies involves tumorigenesis from choledochal cysts.
Conclusion
Smooth muscle distribution pattern of choledochal cyst may predict postoperative complication, raising clinical implications of smooth muscle patterns in postoperative management of choledochal cysts.</description><identifier>ISSN: 0002-9173</identifier><identifier>EISSN: 1943-7722</identifier><identifier>DOI: 10.1093/ajcp/aqaa002</identifier><identifier>PMID: 32010932</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Bile ducts ; Biliary tract diseases ; Carcinoma ; Cholangitis ; Complications ; Cysts ; Development and progression ; Diagnosis ; Dysplasia ; Gallbladder ; Health aspects ; Irritation ; Metaplasia ; Mucosa ; Physiological aspects ; Smooth muscle ; Stricture ; Surgery ; Tumorigenesis</subject><ispartof>American journal of clinical pathology, 2020-06, Vol.153 (6), p.760-771</ispartof><rights>American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com 2020</rights><rights>American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><rights>COPYRIGHT 2020 Oxford University Press</rights><rights>American Society for Clinical Pathology, 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-d31cd12e21e0e84c09b7df26abb579bec980201c3a4cb7122788fa19075c567b3</citedby><cites>FETCH-LOGICAL-c456t-d31cd12e21e0e84c09b7df26abb579bec980201c3a4cb7122788fa19075c567b3</cites><orcidid>0000-0002-8888-6007</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1583,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32010932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hwang, Hee Sang</creatorcontrib><creatorcontrib>Kim, Mee-Jeong</creatorcontrib><creatorcontrib>Lee, Seung-Soo</creatorcontrib><creatorcontrib>Lee, Jae Hoon</creatorcontrib><creatorcontrib>Song, Ki Byung</creatorcontrib><creatorcontrib>Kim, Hyoung Jung</creatorcontrib><creatorcontrib>Hwang, Shin</creatorcontrib><creatorcontrib>Lee, Sung Koo</creatorcontrib><creatorcontrib>Kim, Myung-Hwan</creatorcontrib><creatorcontrib>Hong, Seung-Mo</creatorcontrib><title>Smooth Muscle Distribution Patterns of Choledochal Cysts and Their Implications for Pathogenesis and Postoperative Complications</title><title>American journal of clinical pathology</title><addtitle>Am J Clin Pathol</addtitle><description>Abstract
Objectives
Histopathologic characteristics of choledochal cysts and their clinical implications have not been previously comprehensively studied.
Methods
Smooth muscle distribution patterns and other histologic findings (inflammation, metaplasia, dysplasia, and heterotopia) in 233 surgically resected choledochal cysts were evaluated.
Results
Mean patient age was 23.3 ± 19.8 years, with male:female ratio of 0.3. Most cases were Todani type I (175 cases, 75.1%) or IVa (56 cases, 24.1%). Choledochal cysts with thin scattered/no muscle fiber (175 cases, 75.1%) were the predominant pattern and were associated with more frequent postoperative biliary stricture (P = .031), less frequent pyloric metaplasia (P = .016), and mucosal smooth muscle aggregates (P < .001) compared to cysts with thick muscle bundles. Severe chronic cholangitis (P = .049), pyloric metaplasia (P = .019), mucosal smooth muscle aggregates (P < .001), biliary intraepithelial neoplasia (P = .021), and associated bile duct (P = .021) and gallbladder carcinomas (P = .03) were more common in adults (age >20 years vs ≤20 years), suggesting that chronic irritation in association with developmental anomalies involves tumorigenesis from choledochal cysts.
Conclusion
Smooth muscle distribution pattern of choledochal cyst may predict postoperative complication, raising clinical implications of smooth muscle patterns in postoperative management of choledochal cysts.</description><subject>Bile ducts</subject><subject>Biliary tract diseases</subject><subject>Carcinoma</subject><subject>Cholangitis</subject><subject>Complications</subject><subject>Cysts</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Dysplasia</subject><subject>Gallbladder</subject><subject>Health aspects</subject><subject>Irritation</subject><subject>Metaplasia</subject><subject>Mucosa</subject><subject>Physiological aspects</subject><subject>Smooth muscle</subject><subject>Stricture</subject><subject>Surgery</subject><subject>Tumorigenesis</subject><issn>0002-9173</issn><issn>1943-7722</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kdFr1TAUh4M43HX65rMEfNAHuyVp0rSPo043mDhwPoc0PV1zaZsuSYW9-acv9V43FZE8BA7f9-Mcfgi9ouSYkio_0Vszn-hbrQlhT9CGVjzPpGTsKdqQNMoqKvND9DyELSGUlYQ_Q4c5I6vLNujH19G52OPPSzAD4A82RG-bJVo34SsdI_gpYNfhuncDtM70esD1XYgB66nF1z1Yjy_GebBGr07AnfOr2LsbmCDYHXflQnQz-MR8B1y734QX6KDTQ4CX-_8Ifft4dl2fZ5dfPl3Up5eZ4aKIWZtT01IGjAKBkhtSNbLtWKGbRsiqAVOVJB1lcs1NIyljsiw7TSsihRGFbPIj9G6XO3t3u0CIarTBwDDoCdwSFMsFyTkthUzom7_QrVv8lLZTjDMhJC0of6Ru9ADKTp2LXps1VJ0WXDBeyJ9Zx_-g0mthtMZN0Nk0_0N4vxOMdyF46NTs7aj9naJEraWptXC1Lzzhr_e7Ls0I7QP8q-EEvN0Bbpn_H3UPZty1GQ</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Hwang, Hee Sang</creator><creator>Kim, Mee-Jeong</creator><creator>Lee, Seung-Soo</creator><creator>Lee, Jae Hoon</creator><creator>Song, Ki Byung</creator><creator>Kim, Hyoung Jung</creator><creator>Hwang, Shin</creator><creator>Lee, Sung Koo</creator><creator>Kim, Myung-Hwan</creator><creator>Hong, Seung-Mo</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8888-6007</orcidid></search><sort><creationdate>20200601</creationdate><title>Smooth Muscle Distribution Patterns of Choledochal Cysts and Their Implications for Pathogenesis and Postoperative Complications</title><author>Hwang, Hee Sang ; Kim, Mee-Jeong ; Lee, Seung-Soo ; Lee, Jae Hoon ; Song, Ki Byung ; Kim, Hyoung Jung ; Hwang, Shin ; Lee, Sung Koo ; Kim, Myung-Hwan ; Hong, Seung-Mo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-d31cd12e21e0e84c09b7df26abb579bec980201c3a4cb7122788fa19075c567b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Bile ducts</topic><topic>Biliary tract diseases</topic><topic>Carcinoma</topic><topic>Cholangitis</topic><topic>Complications</topic><topic>Cysts</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Dysplasia</topic><topic>Gallbladder</topic><topic>Health aspects</topic><topic>Irritation</topic><topic>Metaplasia</topic><topic>Mucosa</topic><topic>Physiological aspects</topic><topic>Smooth muscle</topic><topic>Stricture</topic><topic>Surgery</topic><topic>Tumorigenesis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hwang, Hee Sang</creatorcontrib><creatorcontrib>Kim, Mee-Jeong</creatorcontrib><creatorcontrib>Lee, Seung-Soo</creatorcontrib><creatorcontrib>Lee, Jae Hoon</creatorcontrib><creatorcontrib>Song, Ki Byung</creatorcontrib><creatorcontrib>Kim, Hyoung Jung</creatorcontrib><creatorcontrib>Hwang, Shin</creatorcontrib><creatorcontrib>Lee, Sung Koo</creatorcontrib><creatorcontrib>Kim, Myung-Hwan</creatorcontrib><creatorcontrib>Hong, Seung-Mo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of clinical pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hwang, Hee Sang</au><au>Kim, Mee-Jeong</au><au>Lee, Seung-Soo</au><au>Lee, Jae Hoon</au><au>Song, Ki Byung</au><au>Kim, Hyoung Jung</au><au>Hwang, Shin</au><au>Lee, Sung Koo</au><au>Kim, Myung-Hwan</au><au>Hong, Seung-Mo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Smooth Muscle Distribution Patterns of Choledochal Cysts and Their Implications for Pathogenesis and Postoperative Complications</atitle><jtitle>American journal of clinical pathology</jtitle><addtitle>Am J Clin Pathol</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>153</volume><issue>6</issue><spage>760</spage><epage>771</epage><pages>760-771</pages><issn>0002-9173</issn><eissn>1943-7722</eissn><abstract>Abstract
Objectives
Histopathologic characteristics of choledochal cysts and their clinical implications have not been previously comprehensively studied.
Methods
Smooth muscle distribution patterns and other histologic findings (inflammation, metaplasia, dysplasia, and heterotopia) in 233 surgically resected choledochal cysts were evaluated.
Results
Mean patient age was 23.3 ± 19.8 years, with male:female ratio of 0.3. Most cases were Todani type I (175 cases, 75.1%) or IVa (56 cases, 24.1%). Choledochal cysts with thin scattered/no muscle fiber (175 cases, 75.1%) were the predominant pattern and were associated with more frequent postoperative biliary stricture (P = .031), less frequent pyloric metaplasia (P = .016), and mucosal smooth muscle aggregates (P < .001) compared to cysts with thick muscle bundles. Severe chronic cholangitis (P = .049), pyloric metaplasia (P = .019), mucosal smooth muscle aggregates (P < .001), biliary intraepithelial neoplasia (P = .021), and associated bile duct (P = .021) and gallbladder carcinomas (P = .03) were more common in adults (age >20 years vs ≤20 years), suggesting that chronic irritation in association with developmental anomalies involves tumorigenesis from choledochal cysts.
Conclusion
Smooth muscle distribution pattern of choledochal cyst may predict postoperative complication, raising clinical implications of smooth muscle patterns in postoperative management of choledochal cysts.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>32010932</pmid><doi>10.1093/ajcp/aqaa002</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-8888-6007</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9173 |
| ispartof | American journal of clinical pathology, 2020-06, Vol.153 (6), p.760-771 |
| issn | 0002-9173 1943-7722 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2350341857 |
| source | Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Bile ducts Biliary tract diseases Carcinoma Cholangitis Complications Cysts Development and progression Diagnosis Dysplasia Gallbladder Health aspects Irritation Metaplasia Mucosa Physiological aspects Smooth muscle Stricture Surgery Tumorigenesis |
| title | Smooth Muscle Distribution Patterns of Choledochal Cysts and Their Implications for Pathogenesis and Postoperative Complications |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-12T20%3A20%3A57IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Smooth%20Muscle%20Distribution%20Patterns%20of%20Choledochal%20Cysts%20and%20Their%20Implications%20for%20Pathogenesis%20and%20Postoperative%20Complications&rft.jtitle=American%20journal%20of%20clinical%20pathology&rft.au=Hwang,%20Hee%20Sang&rft.date=2020-06-01&rft.volume=153&rft.issue=6&rft.spage=760&rft.epage=771&rft.pages=760-771&rft.issn=0002-9173&rft.eissn=1943-7722&rft_id=info:doi/10.1093/ajcp/aqaa002&rft_dat=%3Cgale_proqu%3EA645246757%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2425571614&rft_id=info:pmid/32010932&rft_galeid=A645246757&rft_oup_id=10.1093/ajcp/aqaa002&rfr_iscdi=true |