Hepatobiliary cystadenoma with mesenchymal stroma--a case report.

Hepatobiliary cystadenoma with mesenchymal stroma (HCMS) is a rare lesion characterized by multiloculated cyst lined by columnar epithelium ad mesenchymal stroma. It occurs exclusively in females and is intrahepatic in location with only 17% cases arising in extrahepatic biliary tree. Exact histogenesis is not known, but it is hypothesized the HCMS arises from ectopic embryonic tissue destined to form the adult gall bladder. HCMS has got a malignant potential and requires radical excision.

Spectrum of clinico-pathological changes in Barrett oesophagus.

OBJECTIVES: Barrett oesophagus is replacement of squamous epithelium to specialised intestinal metaplasia. It is associated with an increased risk for adenocarcinoma which develops through dysplasia. The aim of this retrospective study was to determine the relative age of occurrence and incidence of dysplasia in this part of our country. METHODS: Between January 1999 and June 2002 we diagnosed 13 cases of Barrett oesophagus. Sections were stained with routine H and E and special stain alcian blue (AB)--PAS at pH 2.5. RESULTS: Out of 55 patients with symptoms of gastro-oesophageal reflux disease, 13 cases were diagnosed as Barrett oesophagus. There were 8 males and 5 females. Majority of the patients (77%) were between 20-40 years of age. At endoscopy, in 84.6% patients, lesions were in the form of islands of red mucosa. On histology examination, in 6 cases, squamous epithelium was replaced by intestinal epithelium containing goblet cells and in 7 cases it was replaced by gastric epithelium. Associated dysplasia was not seen in any of the case, while one case showed associated adenocarcinoma. CONCLUSION: Barrett oesophagus is seen in a younger population amongst Indians. A male predominance is noted, but is not as high as reported in Western literature. There is a paucity of patients with pure dysplasia in Barrett metaplasia. Despite the fact that there are a number of patients presenting with Barrett esophagus and carcinoma, very few patients present with dysplasia, indicating that Barrett oesophagus is a silent disease presenting later as a carcinoma.