title: Clinicopathological characterization of so-called "cholangiocarcinoma with intraductal papillary growth" with respect to "intraductal papillary neoplasm of bile duct (IPNB)".
abstract: Cholangiocarcinoma (CC) of the biliary tract occasionally presents a predominant intraductal papillary growth in the bile ducts, called as biliary tract carcinoma (BTC) of papillary growth (PG) and intrahepatic CC (ICC) of intraductal growth (IG) type. Recently, intraductal papillary neoplasm of bile duct (IPNB) has been proposed as a pre-invasive biliary neoplasm. This study was performed to characterize pathologically BTC of PG type and ICC of IG type with respect to IPNB. It was found that 126 of such 154 CCs (81.8%) fulfilled the criteria of IPNB, while the remaining 28 cases showed different histologies, such as tubular adenocarcinoma and carcinosarcoma. These IPNBs occurred in old aged patients with a male predominance, and the left lobe was rather frequently affected in the liver. A majority of these cases were high grade IPNB (43 cases) and invasive IPNB (77 cases), while low grade IPNB was rare (6 cases). Pancreatobiliary type was predominant (48 cases) followed by gastric (30 cases), intestinal (29 cases) and oncocytic (19 cases) types. Mucus hypersecretion was found in 45 cases, and this was frequent in IPNB at the intrahepatic large bile duct and hilar bile ducts but rare at the extrahepatic bile ducts. Interestingly, 36 cases of high grade and invasive IPNBs contained foci of moderately differentiated adenocacinoma within the intraductal papillary tumor. In conclusion, a majority of ICC of IG type and BTC of PG type could be regarded as a IPNB lineage, and clinically detectable IPNBs were already a malignant papillary lesion.
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine Kanazawa ; Department of Pathology, Shizuoka Cancer Center Shizuoka.
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine Kanazawa.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Pathology, National Cancer Center Tokyo.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Ojima
authors.affiliation: Department of Pathology, National Cancer Center Tokyo.
authors.forename: Yae
authors.initials: Y
authors.lastname: Kanai
authors.affiliation: Department of Pathology, Kyushu University Graduate School of Medicine Fukuoka.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.affiliation: Department of Gastrointestinal Surgery, Tokyo Women's College of Medicine Tokyo.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Gastrointestinal Surgery, Tokyo Women's College of Medicine Tokyo.
authors.forename: Shun-ichi
authors.initials: S
authors.lastname: Ariizumi
authors.affiliation: Department of Pathology, Tokyo Women's College of Medicine Tokyo.
authors.forename: Toru
authors.initials: T
authors.lastname: Furukawa
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Tohoku University Graduate School of Medicine Sendai.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Tohoku University Graduate School of Medicine Sendai.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
authors.affiliation: Department of Hepatobiliary Pancreatic Surgery, Kanazawa University Graduate of Medicine Kagoshima, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000145:classification / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D021441:Carcinoma, Pancreatic Ductal / Q000145:classification / Q000473:pathology*; D002291:Carcinoma, Papillary / Q000145:classification / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000145:classification / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010641:Phenotype
keywords: Biliary tree; intraductal cholangiocarcinoma; intraductal papillary neoplasm; papillary cholangiocarcinoma; phenotype