A Case in which an Intraductal Papillary Neoplasm of the Bile Duct Was Surgically Resected 12 Years after the Initial Diagnosis

Tsujimae, Masahiro; Sakai, Arata; Masuda, Atsuhiro; Inomata, Noriko; Masuda, Shōgo; Gonda, Masanori; Abe, Shohei; Yamakawa, K.; Ashina, Shigeto; Kakihara, Maya; Yamada, Yasutaka; Tanaka, Takeshi; Tanaka, Shunta; Nakano, Ryota; Ikegawa, Takuya; Kobayashi, Takashi; Shiomi, Hideyuki; Ajiki, Tetsuo; Fukumoto, Takumi; Ito, Tomoo; Kodama, Yuzo

doi:10.2169/internalmedicine.4891-20

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…The size of IPNBs, including cystic lesions, ranges from 0.5 to 16 cm (median: 2.2–6.0 cm) [ 37 , 66 , 91 , 92 , 93 ]. On the affected mucosa, the height of the main tumor from the adjacent biliary mucosa is at least 5 mm from the adjacent biliary mucosa in typical cases; however, some papillary neoplasms with a similar histopathology that are <5 mm but >3 mm in height are occasionally encountered [ 94 ].…”

Section: Pathologies Of Ipnbsmentioning

confidence: 99%

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: Pathologies Of Ipnbsmentioning

confidence: 99%

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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“…We found 20 cases with complete data through October 2023 in the PubMed database using "intraductal oncocytic papillary neoplasm of the bile duct" as the search query (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). The information related to this search is presented in Table 1.…”

Section: Literature Surveymentioning

confidence: 99%

A missed case of intraductal oncocytic papillary neoplasm associated with missed stones in extrahepatic bile duct: a case report

Xie,

Zhang,

Meng

et al. 2024

Front. Oncol.

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The pathological features of intraductal oncocytic papillary neoplasm (IOPN) of the bile duct include tumor cells that are rich in eosinophilic cytoplasm and arranged in papillary structures. Herein, we report a missed case of IOPN of the bile duct because of concomitant gallstones. A 70-year-old woman was hospitalized with upper abdominal discomfort. The primary diagnosis was choledocholithiasis following imaging examination. However, an unidentified mass was detected after the gallstones were removed. The mass appeared as many papillary protuberances surrounded by fish-egg-like mucosa when viewed by the choledochoscope and was confirmed as IOPN by pathological examination. The patient underwent choledochectomy and no recurrence was observed at the 6-month follow-up examination. In this report, peroral choledochoscopy demonstrated its advantages for the diagnosis of biliary diseases and acquisition of tissue specimens. Therefore, it may solve the challenge related to the lack of preoperative pathological evidence for bile duct tumors.

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“…The size of IPNBs, including cystic lesions, has been described as 0.5 to 17 cm (median, 2.2–6.0 cm). [ 31 , 42 , 47 , 48 ]…”

Section: Introductionmentioning

confidence: 99%

Intraductal papillary neoplasms of the bile ducts—what can be seen with ultrasound?

Möller,

Braden,

Jenssen

et al. 2023

Endosc Ultrasound

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Intraductal papillary neoplasm of the bile ducts is a rare tumor. Characteristic features include bile duct dilatation, cystic lesions with communication to the bile ducts, and intraluminal solid nodules arising from the bile duct wall. As in pancreatic intraductal papillary mucinous neoplasia, intestinal, pancreaticobiliary, gastric, and oncocytic types are described. Intraductal papillary neoplasm of the bile ducts has a high potential for malignancy, and patients should be surgically resected when possible. In this review, the complex imaging diagnosis is presented. The main focus is on contrast-enhanced ultrasound, an established method for many other indications whose potential on the biliary system should be better exploited. In the present article, typical contrast-enhanced ultrasound findings in intraductal papillary neoplasm of the bile ducts are demonstrated.

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A Case in which an Intraductal Papillary Neoplasm of the Bile Duct Was Surgically Resected 12 Years after the Initial Diagnosis

Cited by 5 publications

References 11 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

A missed case of intraductal oncocytic papillary neoplasm associated with missed stones in extrahepatic bile duct: a case report

Intraductal papillary neoplasms of the bile ducts—what can be seen with ultrasound?

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