Intraductal oncocytic papillary neoplasm of the bile duct: the first case of peribiliary gland origin.
We report herein the first case of intraductal oncocytic papillary neoplasm of the bile duct arising from a peribiliary gland of the left hepatic duct. The patient was a 63-year-old Japanese man. Radiological and cholangioscopic examinations revealed intraductal tumor of the left hepatic duct. After pathological diagnosis of adenocarcinoma by cholangioscopic biopsy, a surgical hepatobiliary resection was performed. Pathological examination revealed papillary tumor in the left hepatic duct. Histologically, the tumor was identified as papillary neoplasm comprising oncocytic cells and delicate fibrovascular cores. Interestingly, this tumor originated from the cystic space in the bile duct wall. This cystic space was histologically identified as a cystically dilated peribiliary gland. Carcinoma in situ was observed in this cystic peribiliary gland at the bottom of the tumor, but not on any areas of biliary epithelium. This case suggests that intraductal papillary neoplasm can arise from both biliary epithelium and peribiliary glands.
Nakanishi
Yoshitsugu
Y
Division of Cancer Medicine, Department of Surgical Oncology, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo, 060-8638, Japan. y.nakanishi@mac.com
Zen
Yoh
Y
Hirano
Satoshi
S
Tanaka
Eiichi
E
Takahashi
Osamu
O
Yonemori
Atsuya
A
Doumen
Hiromitsu
H
Kawakami
Hiroshi
H
Itoh
Tomoo
T
Nakanuma
Yasuni
Y
Kondo
Satoshi
S