Updates on Precancerous Lesions of the Biliary Tract: Biliary Precancerous Lesion

Ainechi, Sanaz; Lee, Hwajeong

doi:10.5858/arpa.2015-0396-rs

Cited by 37 publications

(29 citation statements)

References 25 publications

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“…The close association of GP2 IgA with tumorigenesis in PSC is another intriguing point regarding a putative pathophysiological role of GP2 IgA. The two main precursor lesions of cholangiocarcinoma are biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct [148].…”

Section: Putative Role Of Gp2 Iga In the Pathophysiology Of Pscmentioning

confidence: 99%

The search for the Holy Grail: autoantigenic targets in primary sclerosing cholangitis associated with disease phenotype and neoplasia

Lopens

Krawczyk

Papp

et al. 2020

Autoimmun Highlights

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Unlike in other autoimmune liver diseases such as autoimmune hepatitis and primary biliary cholangitis, the role and nature of autoantigenic targets in primary sclerosing cholangitis (PSC), a progressive, chronic, immune-mediated, life threatening, genetically predisposed, cholestatic liver illness, is poorly elucidated. Although anti-neutrophil cytoplasmic antibodies (ANCA) have been associated with the occurrence of PSC, their corresponding targets have not yet been identified entirely. Genome-wide association studies revealed a significant number of immune-related and even disease-modifying susceptibility loci for PSC. However, these loci did not allow discerning a clear autoimmune pattern nor do the therapy options and the male gender preponderance in PSC support a pathogenic role of autoimmune responses. Nevertheless, PSC is characterized by the co-occurrence of inflammatory bowel diseases (IBD) demonstrating autoimmune responses. The identification of novel autoantigenic targets in IBD such as the major zymogen granule membrane glycoprotein 2 (GP2) or the appearance of proteinase 3 (PR3) autoantibodies (autoAbs) have refocused the interest on a putative association of loss of tolerance with the IBD phenotype and consequently with the PSC phenotype. Not surprisingly, the report of an association between GP2 IgA autoAbs and disease severity in patients with PSC gave a new impetus to autoAb research for autoimmune liver diseases. It might usher in a new era of serological research in this field. The mucosal loss of tolerance against the microbiota-sensing GP2 modulating innate and adaptive intestinal immunity and its putative role in the pathogenesis of PSC will be elaborated in this review. Furthermore, other potential PSC-related autoantigenic targets such as the neutrophil PR3 will be discussed. GP2 IgA may represent a group of new pathogenic antibodies, which share characteristics of both type 2 and 3 of antibody-mediated hypersensitive reactions according to Coombs and Gell.

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Section: Putative Role Of Gp2 Iga In the Pathophysiology Of Pscmentioning

confidence: 99%

The search for the Holy Grail: autoantigenic targets in primary sclerosing cholangitis associated with disease phenotype and neoplasia

Lopens

Krawczyk

Papp

et al. 2020

Autoimmun Highlights

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“…Radiology studies cannot detect biliary intraepithelial neoplasia as it is an atypical growth of the biliary epithelium which is identified histologically. However, the subtypes of IPMN-B have distinct radiologic features that can be diagnosed using multiple imaging modalities [1]. Therefore, it is important for a radiologist to be familiar with the various imaging characteristics of this uncommon disease process in order to detect these lesions early enough for surgical resection to be potentially curative and before transformation to invasive cholangiocarcinoma can occur.…”

Section: Discussionmentioning

confidence: 99%

Intraductal papillary mucinous neoplasm of the biliary tract: A precursor lesion to cholangiocarcinoma

Ritchie

Okamoto

White

2019

Radiology Case Reports

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Intraductal papillary mucinous neoplasm of the biliary tract (IPMN-B) is an increasingly recognized pathologic entity characterized by intraluminal papillary masses and increased mucin secretion, resulting in obstruction and dilation of the biliary tree. These lesions, rarely seen in clinical practice in the United States, are now considered to be important precursors for the development of cholangiocarcinoma. Therefore, it is critical that radiologists become familiar with the radiographic manifestations of IPMN-B in order to diagnosis these lesions at a time when surgical resection may be curative. Here we report a pathologically confirmed case of IPMN-B in a patient with chronic ulcerative colitis and subsequently discuss the main radiographic manifestations of this rare condition across multiple imaging modalities.

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“…Especially with severe atypia, the lesions are identical to in situ carcinoma. This kind of epithelial carcinoma is often detected as a lesion accompanied by invasive carcinoma [7], while in situ carcinoma alone is rarely detected. According to our previous study [8], only 3 cases of in situ carcinoma were found in 545 consecutive resections of perihilar cholangiocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

A case of small in situ perihilar cholangiocarcinoma incidentally accompanied by benign bile duct stricture after open cholecystectomy

et al. 2019

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BackgroundIn situ cholangiocarcinoma is difficult to detect by imaging studies. Thus, cholangiocarcinoma is rarely resected with a preoperative definitive diagnosis, especially nonpapillary flat type in situ carcinoma, which is extremely rare.Case presentationA 70-year old man was diagnosed with gallbladder cancer and received open cholecystectomy with lymphadenectomy at a local hospital. Histologically, the tumor was localized in the mucosal layer, and no lymph node metastases were found. Three months later, hilar bile duct stricture due to delayed bile duct ischemia was found. Then, biliary drainage was performed with endoscopic biliary stenting. Three months later, the patient experienced cholangitis with septic shock, and percutaneous transhepatic biliary drainage (PTBD) into the left intrahepatic bile duct was performed. Unexpectedly, the aspiration bile cytology of the PTBD catheter showed malignant cells, and the patient was referred to our clinic for possible surgical treatment. According to additional studies, the hilar bile duct stricture was 3 cm in length. None of the imaging studies detected malignant cells in the bile duct around the hilar stricture. The left portal vein was obstructed due to inadvertent puncture of the PTBD. No findings indicated cholangiocarcinoma. We performed left hepatectomy with caudate lobectomy and extrahepatic bile duct resection. The postoperative course was uneventful. In the final pathology, flat type in situ carcinoma was found at the confluence of the right and left hepatic ducts, which was distant from the biliary stricture.ConclusionsWhen a tumor is undetectable but cytology is positive, in situ cholangiocarcinoma may exist; thus, surgery should be carefully considered.

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Updates on Precancerous Lesions of the Biliary Tract: Biliary Precancerous Lesion

Cited by 37 publications

References 25 publications

The search for the Holy Grail: autoantigenic targets in primary sclerosing cholangitis associated with disease phenotype and neoplasia

The search for the Holy Grail: autoantigenic targets in primary sclerosing cholangitis associated with disease phenotype and neoplasia

Intraductal papillary mucinous neoplasm of the biliary tract: A precursor lesion to cholangiocarcinoma

A case of small in situ perihilar cholangiocarcinoma incidentally accompanied by benign bile duct stricture after open cholecystectomy

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