PERIBILIARY GLANDULAR HYPERPLASIA AS A MIMICKER OF MALIGNANCY

Peribiliary glands are a group of tiny glandular structures located along the intrahepatic and extrahepatic bile ducts, and cystic duct. Their major function is to regulate enzyme secretion and turn over, and regeneration of the bile duct epithelium. They are closely associated with conditions like Primary sclerosing cholangitis, Hepatolithiasis and neoplasms like Cholangiocarcinoma. If the hyperplasia is severe enough to cause bile duct obstruction, it will closely mimic biliary neoplasms like cholangiocarcinoma. Unfamiliarity of this rare condition can create false positive diagnosis of malignancy. Hence careful and thorough histopathological examination of the specimen is essential in such cases. Here we report a rare case of extensive peribiliary glandular hyperplasia in association with hepatolithiasis in which a 57-year-old woman with colicky abdominal pain, fever, vomiting, and abdominal distention was diagnosed with multiple strictures of the left hepatic duct and recurrent pyogenic cholangitis. MRI and liver function tests indicated obstruction for which she underwent surgery. Histopathology revealed benign glandular hyperplasia with no malignancy.