Intraductal Papillary Neoplasm of the Bile Duct: Clinical, Imaging, and Pathologic Features

Park, Hyo Jung; Kim, So Yeon; Kim, Hyoung Jung; Lee, Seung Soo; Hong, Gil-Sun; Hong, Seung‐Mo; Lee, Moon-Gyu

doi:10.2214/ajr.17.19261

Cited by 80 publications

(59 citation statements)

References 64 publications

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“…Bile ducts with excessive mucin secretion located upstream and downstream from IPNBs are significantly dilated due to the large amount of mucin in the duct lumen. The anatomical location of IPNBs within or outside the liver parenchyma and the presence or absence of excessive mucin hypersecretion from an IPNB may influence the gross appearance of the IPNB 14,18…”

Section: Heterogeneity In the Pathology Of Ipnbmentioning

confidence: 99%

“…There are several biliary and pancreatic diseases that share many clinical and pathological features5,15,16,18,25,26,30,31 and can be regarded as a spectrum of “biliary diseases with pancreatic counterparts.” The representative diseases are shown in Table 1. The pathological and clinical similarities between IPNB and IPMN have been reported,5,15,18,22,30 suggesting that IPNBs and IPMNs can be included in this spectrum.…”

Section: Similarities Between Ipnb and Pancreatic Ipmnmentioning

confidence: 99%

“…Because of possible recurrent biliary obstruction in all cases and frequent high-grade dysplasia with minimal invasion, all patients with IPNB should be treated 18. All patients without distant metastasis are surgical candidates and should be resected in a manner similar to surgery for cholangiocarcinoma 18,28. If superficial spreading is extensive with a positive resection margin, resection of the extensive biliary tree and pancreaticoduodenectomy may be performed 41…”

Section: Treatmentmentioning

confidence: 99%

“…IPNBs have been the topic of many recent studies, including studies on their clinicopathological features and imaging findings, and it was found that IPNBs show variable gross and histopathological features and biological behaviors 3,8–18. It is noteworthy that the incidence of stromal invasion and the histologic features differ among several of the proposed subcategories of IPNB 9,12,17,19.…”

Section: Introductionmentioning

confidence: 99%

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Characterization of Intraductal Papillary Neoplasm of the Bile Duct with Respect to the Histopathologic Similarities to Pancreatic Intraductal Papillary Mucinous Neoplasm

2019

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Intraductal papillary neoplasms of the bile duct (IPNBs) are known to show various pathologic features and biological behaviors. Recently, two categories of IPNBs have been proposed based on their histologic similarities to pancreatic intraductal papillary mucinous neoplasms (IPMNs): type 1 IPNBs, which share many features with IPMNs; and type 2 IPNBs, which are variably different from IPMNs. The four IPNB subtypes were re-evaluated with respect to these two categories. Intestinal IPNBs showing a predominantly villous growth may correspond to type 1, while those showing papillay-tubular or papillay-villous growth correspond to type 2. Regarding gastric IPNB, those with regular foveolar structures with varying numbers of pyloric glands may correspond to type 1, while those with papillary-foveolar structures with gastric immunophenotypes and complicated structures may correspond to type 2. Pancreatobiliary IPNBs that show fine ramifying branching may be categorized as type 1, while others containing many complicated structures may be categorized as type 2. Oncocytic type, which displays solid growth or irregular papillary structures, may correspond to type 2, while papillary configurations with pseudostratified oncocytic lining cells correspond to type 1. Generally, type 1 IPNBs of any subtype develop in the intrahepatic bile ducts, while type 2 IPNBs develop in the extrahepatic bile duct. These findings suggest that IPNBs arising in the intrahepatic ducts are biliary counterparts of IPMNs, while those arising in the extrahepatic ducts display differences from prototypical IPMNs. The recognition of these two categories of IPNBs with reference to IPMNs and their anatomical location along the biliary tree may deepen our understanding of IPNBs.

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Section: Heterogeneity In the Pathology Of Ipnbmentioning

confidence: 99%

Section: Similarities Between Ipnb and Pancreatic Ipmnmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characterization of Intraductal Papillary Neoplasm of the Bile Duct with Respect to the Histopathologic Similarities to Pancreatic Intraductal Papillary Mucinous Neoplasm

2019

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“…Higher incidence in these countries can be attributed to a higher prevalence of risk factors such as endemic hepatolithiasis and Clonorchis infection [7]. Other risk factors include primary sclerosing cholangitis, choledochal cyst, familial adenomatous polyposis, or Gardner syndrome [8].…”

Section: Discussionmentioning

confidence: 99%

Intraductal Papillary Neoplasm of the Bile Duct: A Rare Case of Intrahepatic Space-Occupying Lesion

Dutta

Upadhyay

Jain

et al. 2021

Cureus

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Intraductal papillary neoplasm of the bile duct (IPNB) is a rare tumor and is considered one of the precursor lesions for cholangiocarcinoma. Though relatively common in the far east countries, it is uncommon in the Indian population. A 67-year-old gentleman presented with vague upper abdominal pain with no history of fever, jaundice, melena, or hematemesis. An abdominal ultrasound showed a solid cystic lesion in the left lobe of the liver with upstream dilatation of bile ducts. Computed tomography and magnetic resonance imaging showed similar findings. With a differential diagnosis of intrahepatic cholangiocarcinoma, intraductal papillary neoplasm, and biliary cystadenoma, he underwent robotic-assisted left hepatectomy. Histopathology was suggestive of IPNB. Following surgery, he had an uneventful recovery and was advised for follow-up visits every six months. A clinical, radiological, and pathological profile of this rare tumor has been described here with a review of the existing literature.

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The multidisciplinary management of cholangiocarcinoma

Ohaegbulam

Koethe

Fung

et al. 2022

Cancer

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Cholangiocarcinoma is a lethal malignancy of the biliary epithelium that can arise anywhere along the biliary tract. Surgical resection confers the greatest likelihood of long‐term survivability. However, its insidious onset, difficult diagnostics, and resultant advanced presentation render the majority of patients unresectable, highlighting the importance of early detection with novel biomarkers. Developing liver‐directed therapies and emerging targeted therapeutics may offer improved survivability for patients with unresectable or advanced disease. In this article, the authors review the current multidisciplinary standards of care in resectable and unresectable cholangiocarcinoma, with an emphasis on novel biomarkers for early detection and nonsurgical locoregional therapy options.

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Intraductal Papillary Neoplasm of the Bile Duct: Clinical, Imaging, and Pathologic Features

Abstract: The concept of IPNB has been evolving. Because the imaging features of IPNB can be variable, different mimickers according to IPNB subtype can be considered. A multimodality approach is essential to obtain an optimal diagnosis and establish treatment plans.

Cited by 80 publications

References 64 publications

Characterization of Intraductal Papillary Neoplasm of the Bile Duct with Respect to the Histopathologic Similarities to Pancreatic Intraductal Papillary Mucinous Neoplasm

Characterization of Intraductal Papillary Neoplasm of the Bile Duct with Respect to the Histopathologic Similarities to Pancreatic Intraductal Papillary Mucinous Neoplasm

Intraductal Papillary Neoplasm of the Bile Duct: A Rare Case of Intrahepatic Space-Occupying Lesion

The multidisciplinary management of cholangiocarcinoma

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