title: Characterization of intraductal papillary neoplasm of bile duct with respect to histopathologic similarities to pancreatic intraductal papillary mucinous neoplasm.
abstract: Intraductal papillary neoplasm of bile duct (IPNB) is a papillary tumor covered by well-differentiated neoplastic epithelium with fine fibrovascular cores in the dilated bile ducts. It reportedly shows similarities to intraductal papillary mucinous neoplasm of pancreas (IPMN), to various degrees. Herein, IPNB was pathologically analyzed by classifying 52 cases into 4 groups based on the histopathologic similarities to IPMN: group A (identical to IPMN, 19 cases), group B (similar to but slightly different from IPMN, 18 cases), group C (vaguely similar to IPMN, 5 cases), and group D (different from IPMN, 10 cases). In group A, intrahepatic and perihilar regions were mainly affected, most cases were of low/intermediate or high grade without invasion, and gastric type was the most common phenotype, followed by oncocytic and intestinal types. In groups C and D, perihilar and distal bile ducts were affected, almost all cases were of high grade with invasion, and most of them were of intestinal and pancreatobiliary phenotypes. Most group B cases were of intestinal phenotype, and all were of high grade with or without invasion. In conclusion, these 4 groups of IPNB showed unique pathologic features and behaviors. Group A cases were less aggressive and shared many features with IPMN, whereas group C and D cases were more aggressive and mainly found in perihilar and distal bile ducts. Group B resembling IPMN was intermediate between them. This classification may be useful in clinical practice and holds promise for a novel approach to analyze IPNB tumorigenesis.
authors.affiliation: Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka 411-8777, Japan. Electronic address: nakanuma@staff.kanazawa-u.ac.jp.
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
authors.affiliation: Department of Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kakuda
authors.affiliation: Department of Hepatobiliary Surgery, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Uesaka
authors.affiliation: Department of Hepatobiliary Surgery, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyata
authors.affiliation: Department of Hepatobiliary Surgery, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Human Pathology, Juntendo University School of Medicine, Tokyo 113-8421, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fukumura
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan.
authors.forename: Motoko
authors.initials: M
authors.lastname: Sasaki
authors.affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Clinical Laboratory, Koshigaya City Hospital, Koshigaya 343-8577, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Takase
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000473:pathology*; D000231:Adenocarcinoma, Papillary / Q000145:classification* / Q000473:pathology; D000368:Aged; D001650:Bile Duct Neoplasms / Q000145:classification* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged
chemical_list: D014408:Biomarkers, Tumor
keywords: Bile duct; Intraductal papillary neoplasm; Invasion; Pancreas; Phenotype