title: Intraductal papillary neoplasm arising from peribiliary glands connecting with the inferior branch of the bile duct of the anterior segment of the liver.
abstract: Intraductal papillary neoplasms of the bile duct are generally thought to arise from neoplastic papillary proliferation of epithelial cells lining the bile duct. We herein report a case with findings that strongly suggested that the biliary cystic tumor might have derived from a peribiliary gland. A 69-year-old female was found to have a cystic lesion with intracystic protrusions at the anterior segment of the right hepatic lobe and underwent hepatic anterior segment resection. Fluoroscopy of the resected specimen injected with contrast medium into the cyst revealed a connection between the cystic lesion and the bile ducts. The cyst was multilocular in appearance. On microscopic examination, the cyst was located within the portal tract of the inferior branch of the anterior segment and connected with the inferior branch of the bile duct. The wall of the hepatic cyst lacked an ovarian-like stroma. The tumor was composed of papillary and glandular components, and the tumor cells were similar to gastric foveolar and pyloric gland epithelia and regarded as adenoma. These tumor cells were positive for MUC 5AC, MUC6, and HIK1083. The tumor was finally diagnosed as an intraductal papillary neoplasm of the bile duct (adenoma, gastric type) arising from a peribiliary gland.
authors: Department of Surgery, National Hospital Organization, Hakodate Hospital, Hakodate, Japan. y.nakanishi@mac.com
authors: Yoshitsugu
authors: Y
authors: Nakanishi
authors: Yasuni
authors: Y
authors: Nakanuma
authors: Masanori
authors: M
authors: Ohara
authors: Toshiyasu
authors: T
authors: Iwao
authors: Noriko
authors: N
authors: Kimura
authors: Takuzo
authors: T
authors: Ishidate
authors: Hiroshi
authors: H
authors: Kijima
mesh_terms: D002759:Adenoma, Bile Duct / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D000368:Aged; D001650:Bile Duct Neoplasms / Q000378:metabolism / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D018292:Cystadenoma, Papillary / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry
chemical_list: D014408:Biomarkers, Tumor