title: Intraductal oncocytic papillary neoplasm of the bile duct: the first case of peribiliary gland origin.
abstract: 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.
authors.affiliation: 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
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Yoh
authors.initials: Y
authors.lastname: Zen
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirano
authors.forename: Eiichi
authors.initials: E
authors.lastname: Tanaka
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahashi
authors.forename: Atsuya
authors.initials: A
authors.lastname: Yonemori
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Doumen
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawakami
authors.forename: Tomoo
authors.initials: T
authors.lastname: Itoh
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kondo