Premalignant lesions of cholangiocarcinoma: characteristics on ultrasonography and MRI

Siripongsakun, Surachate; Sapthanakorn, Withawat; Mekraksakit, Poemlarp; Vichitpunt, Saruda; Chonyuen, Saowalak; Seetasarn, Jitsupa; Bhumiwat, Siwat; Sricharunrat, Thaniya; Srittanapong, Saowanee

doi:10.1007/s00261-019-01951-2

Cited by 16 publications

(28 citation statements)

References 24 publications

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“…IPNB is a rare disease entity with a prevalence of 4% to 15% among bile duct tumors [ 35 , 37 , 42 ]. IPNB was mainly reported in East Asia, and the incidence is regarded to be higher in these countries than in others [ 15 , 39 , 40 , 43 , 44 ]. Zen et al [ 45 ] examined the ratio of IPNB/mucinous cystic neoplasm of liver (MCN-L) and showed this ratio to be 5.7:1 in Seoul but 1:3.0 in Seattle (WA, USA) and 1:6.3 in London (UK).…”

Section: Clinical Features Epidemiology and Imaging And Endoscopimentioning

confidence: 99%

“…The most important morphological changes are the presence of (a) intraductal mass(es) and surrounding intraepithelial neoplastic biliary mucosa, (b) diffuse or segmental bile duct dilatation with or without cystic changes (maximum 126 mm) and (c) ductal and periductal invasion including macro-invasion of the liver [ 3 , 28 , 41 , 42 , 43 , 65 , 66 , 67 ] ( Figure 1 A,B). In ultrasound sonography (US), IPNB was recognizable by variable features, including hyperechoic nodules (37.5%), focal bile duct dilatation (37.5%) and diffuse bile duct dilatation with intraductal nodules (25%) [ 43 ]. A cystic mass may involve more than one lobe [ 66 ].…”

Section: Clinical Features Epidemiology and Imaging And Endoscopimentioning

confidence: 99%

“…MRI with magnetic resonance cholangiography (MRC) may be helpful for differentiating IPNB with an associated invasive carcinoma from non-invasive IPNB with intraepithelial neoplasia [ 67 ]. On computed tomography (CT), almost all cases in a previous report showed bile duct dilatation (98.2%) and an intraductal mass (92.9%) [ 43 ], and the enhancement pattern of IPNB is isodense or hyperdense during the late arterial phase and not hyperdense during the portal-venous and delayed phase. Other findings obtained by CT are infiltration of the neoplasm along the duct wall and intense rim enhancement at the base of the lesion.…”

Section: Clinical Features Epidemiology and Imaging And Endoscopimentioning

confidence: 99%

“…When IPNB exists in the intrahepatic bile ducts, it tends to be found in the left-sided biliary ductal system [ 35 ]. However, in Opisthorchis viverrini (OV)-infected patients, IPNB was found more commonly at the right than left intrahepatic ducts and had more peripheral than central locations [ 43 ]. Extrahepatic IPNBs show more aggressive pathologic features and a higher rate of invasion than intrahepatic IPNBs [ 25 , 30 , 40 , 41 ].…”

Section: Pathologies Of Ipnbsmentioning

confidence: 99%

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Intraductal Papillary Neoplasm of Bile Duct: Updated Clinicopathological Characteristics and Molecular and Genetic Alterations

Nakanuma

Uesaka

Kakuda

et al. 2020

JCM

113

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Intraductal papillary neoplasm of the bile duct (IPNB), a pre-invasive neoplasm of the bile duct, is being established pathologically as a precursor lesion of invasive cholangiocarcinoma (CCA), and at the time of surgical resection, approximately half of IPNBs show stromal invasion (IPNB associated with invasive carcinoma). IPNB can involve any part of the biliary tree. IPNB shows grossly visible, exophytic growth in a dilated bile duct lumen, with histologically villous/papillary neoplastic epithelia with tubular components covering fine fibrovascular stalks. Interestingly, IPNB can be classified into four subtypes (intestinal, gastric, pancreatobiliary and oncocytic), similar to intraductal papillary mucinous neoplasm of the pancreas (IPMN). IPNBs are classified into low-grade and high-grade based on lining epithelial features. The new subclassification of IPNB into types 1 (low-grade dysplasia and high-grade dysplasia with regular architecture) and 2 (high-grade dysplasia with irregular architecture) proposed by the Japan–Korea pathologist group may be useful in the clinical field. The outcome of post-operative IPNBs is more favorable in type 1 than type 2. Recent genetic studies using next-generation sequencing have demonstrated the existence of several groups of mutations of genes: (i) IPNB showing mutations in KRAS, GNAS and RNF43 belonged to type 1, particularly the intestinal subtype, similar to the mutation patterns of IPMN; (ii) IPNB showing mutations in CTNNB1 and lacking mutations in KRAS, GNAS and RNF43 belonged to the pancreatobiliary subtype but differed from IPMN. IPNB showing mutation of TP53, SMAD4 and PIK3CA might reflect complicated and other features characterizing type 2. The recent recognition of IPNBs may facilitate further clinical and basic studies of CCA with respect to the pre-invasive and early invasive stages.

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Section: Clinical Features Epidemiology and Imaging And Endoscopimentioning

confidence: 99%

Section: Clinical Features Epidemiology and Imaging And Endoscopimentioning

confidence: 99%

Section: Clinical Features Epidemiology and Imaging And Endoscopimentioning

confidence: 99%

Section: Pathologies Of Ipnbsmentioning

confidence: 99%

See 2 more Smart Citations

Intraductal Papillary Neoplasm of Bile Duct: Updated Clinicopathological Characteristics and Molecular and Genetic Alterations

Nakanuma

Uesaka

Kakuda

et al. 2020

JCM

113

View full text Add to dashboard Cite

show abstract

“…109 US can detect up to 41% of IPNB as a hypo or hyperechoic mass, bile duct dilatation or both. 109,136 CEUS might facilitate the diagnosis of IPNB excluding sludge, stones and blood clots, but distinguishing invasive IPNB from non-invasive lesions can be challenging. As opposed to US, dynamic CT and MRI with their specific sequences (e.g.…”

Section: Identification Of Preneoplastic Lesionsmentioning

confidence: 99%

Preneoplastic lesions in the liver: Molecular insights and relevance for clinical practice

Desjonqueres

Campani

Marra

et al. 2022

Liver International

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Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) are the most frequent primary liver cancers, accounting for approximately 80% and 15%, respectively. HCC carcinogenesis occurs mostly in cirrhosis and is a complex multi-step process, from precancerous lesions (low-grade and high-grade dysplastic nodules) to progressed HCC.During the different stages of liver carcinogenesis, there is an accumulation of pathological, genetic and epigenetic changes leading to initiation, malignant transformation and finally tumour progression. In contrast, a small subset of HCC occurs in normal liver from the transformation of hepatocellular adenoma (HCA), a benign hepatocellular tumour. The recent molecular classification enables to stratify HCAs according to their risk of complication, in particular malignant transformation, associated with mutations in exon 3 of the catenin beta 1 (CTNNB1) gene. Cholangiocarcinoma (CCA) derives from the multistep malignant transformation of preneoplastic lesions, like biliary intraepithelial neoplasia (BilIN) and intraductal papillary neoplasm of the bile duct (IPNB), for which a pre-operative diagnosis remains difficult. Different genetic alterations are involved in BilIN and IPNB progression, leading to the development of tubular or intestinal adenocarcinoma. The aims of this review are to describe the main clinical and molecular features of preneoplastic lesions leading to the development of HCC and CCA, their implications in clinical practice and the perspectives for future research.

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Preinvasive Intraductal Biliary Neoplasm: Biliary Intraepithelial Neoplasm and Intraductal Papillary Neoplasm of Bile Duct

Nakanuma

Uesaka

Takato

2022

The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases

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Premalignant lesions of cholangiocarcinoma: characteristics on ultrasonography and MRI

Cited by 16 publications

References 24 publications

Intraductal Papillary Neoplasm of Bile Duct: Updated Clinicopathological Characteristics and Molecular and Genetic Alterations

Intraductal Papillary Neoplasm of Bile Duct: Updated Clinicopathological Characteristics and Molecular and Genetic Alterations

Preneoplastic lesions in the liver: Molecular insights and relevance for clinical practice

Preinvasive Intraductal Biliary Neoplasm: Biliary Intraepithelial Neoplasm and Intraductal Papillary Neoplasm of Bile Duct

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