Morphology of intraductal papillary neoplasm of the bile ducts: radiologic-pathologic correlation.
OBJECTIVE
Intraductal papillary neoplasm of the bile duct (IPN-B) is known as a premalignant lesion of invasive cholangiocarcinoma. The purpose of this study was for radiologic-pathologic correlation of morphologic features of IPN-B and to correlate the subclassifications with biological behavior in regard to the bile duct wall invasion.


METHODS
A pathologist classified gross morphology of 75 cases (44 men and 31 women, age range, 39-85) of histopathologically proven IPN-B into polypoid, cast-like, superficial-spreading, and cyst-forming type. Preoperative images were retrospectively reviewed by two observers independently and classified the gross appearance of intraductal tumors into the four types.


RESULTS
The pathologist classified macroscopic appearances of 75 cases of IPN-B into polypoid type in 26, cast-like intraductal growth in 17, superficial-spreading growth in 21, and cyst-forming type in 11. Two observers classified image findings in accordance with pathologist's classification in 58 and 57 (77% and 76%) among the 75 cases of IPN-B, respectively; 18 and 19 of 26 cases of polypoid type, 14 and 14 of 17 cases of cast-like growth type, 16 and 19 of 21 cases of superficial-spreading type, 10 and 5 of 11 cases of cyst-forming type, respectively. Interobserver agreement for subclassification of tumor morphology was in the category of good agreement (k = 0.651). There was no correlation between morphological subclassification and tendency to invasive cholangiocarcinoma.


CONCLUSIONS
IPN-Bs can be classified morphologically into polypoid, cast-like growth, superficial-spreading, and cystic type, but there is no correlation between the types and tendency to invasive cholangiocarcinoma.
Kim
Heejung
H
Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
Lim
Jae Hoon
JH
Jang
Kee Taek
KT
Kim
Min Ju
MJ
Lee
Jongmee
J
Lee
Ji Young
JY
Choi
Dongil
D
Lim
Hyo Keun
HK
Choi
Dong Wook
DW
Lee
Jong Kyun
JK
Baron
Richard
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D003287:Contrast Media