Biliary cystic tumors with bile duct communication: a cystic variant of intraductal papillary neoplasm of the bile duct View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2006-06-02

AUTHORS

Yoh Zen, Takahiko Fujii, Keita Itatsu, Koichi Nakamura, Fumio Konishi, Shinji Masuda, Takeshi Mitsui, Yasuyuki Asada, Shouji Miura, Shiro Miyayama, Takeshi Uehara, Tsutomu Katsuyama, Tetsuo Ohta, Hiroshi Minato, Yasuni Nakanuma

ABSTRACT

Biliary cystic tumors, which are also called biliary cystadenoma and cystadenocarcinoma, are thought to be a heterogeneous disease entity, and some of them are known to show a luminal communication to the bile duct. In this study, we examined the clinicopathological features of nine cases of biliary cystic tumors with bile duct communication. They were composed of five males and four females with an average age of 67 years (52–84 years). They were multilocular (eight cases) or unilocular (one case), and all cases contained mucinous fluid. A direct luminal communication with the bile ducts was identified in five cases on preoperative or intraoperative cholangiographies. Biliary cystic tumors examined in this study were histologically adenoma (one case), adenocarcinoma in situ (six cases), and adenocarcinoma associated with microinvasive mucinous carcinoma (two cases). One case of adenocarcinoma in situ also had the adenoma component (adenocarcinoma in adenoma). Dysplastic mucinous epithelium proliferated in flat, micropapillary and papillary fashions within the intracystic spaces. Intraepithelial neoplasm was observed within non-dilated adjacent bile ducts, suggesting a direct luminal communication between the cystic tumors and the bile duct. Ovarian-like stroma was not observed in their walls in any cases. Immunohistochemically, seven cases expressed MUC1 or MUC2 in the neoplastic biliary epithelium. All cases except one were alive without any evidences of tumor recurrence after total excision (3–156 months after surgery). These clinicopathological features resembled those of intraductal papillary neoplasm of the bile duct, which had been reported as a biliary counterpart of pancreatic intraductal papillary mucinous neoplasm. In conclusion, biliary cystic tumors with bile duct communication could be regarded as intraductal papillary neoplasm with a prominent cystic dilatation of the bile duct and mucin retention, rather than true biliary cystic neoplasms. More... »

PAGES

1243-1254

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/modpathol.3800643

DOI

http://dx.doi.org/10.1038/modpathol.3800643

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1046427163

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/16741522


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34 schema:description Biliary cystic tumors, which are also called biliary cystadenoma and cystadenocarcinoma, are thought to be a heterogeneous disease entity, and some of them are known to show a luminal communication to the bile duct. In this study, we examined the clinicopathological features of nine cases of biliary cystic tumors with bile duct communication. They were composed of five males and four females with an average age of 67 years (52–84 years). They were multilocular (eight cases) or unilocular (one case), and all cases contained mucinous fluid. A direct luminal communication with the bile ducts was identified in five cases on preoperative or intraoperative cholangiographies. Biliary cystic tumors examined in this study were histologically adenoma (one case), adenocarcinoma in situ (six cases), and adenocarcinoma associated with microinvasive mucinous carcinoma (two cases). One case of adenocarcinoma in situ also had the adenoma component (adenocarcinoma in adenoma). Dysplastic mucinous epithelium proliferated in flat, micropapillary and papillary fashions within the intracystic spaces. Intraepithelial neoplasm was observed within non-dilated adjacent bile ducts, suggesting a direct luminal communication between the cystic tumors and the bile duct. Ovarian-like stroma was not observed in their walls in any cases. Immunohistochemically, seven cases expressed MUC1 or MUC2 in the neoplastic biliary epithelium. All cases except one were alive without any evidences of tumor recurrence after total excision (3–156 months after surgery). These clinicopathological features resembled those of intraductal papillary neoplasm of the bile duct, which had been reported as a biliary counterpart of pancreatic intraductal papillary mucinous neoplasm. In conclusion, biliary cystic tumors with bile duct communication could be regarded as intraductal papillary neoplasm with a prominent cystic dilatation of the bile duct and mucin retention, rather than true biliary cystic neoplasms.
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42 MUC2
43 adenocarcinoma
44 adenoma component
45 adjacent bile ducts
46 age
47 average age
48 bile duct
49 bile duct communication
50 biliary counterpart
51 biliary cystadenoma
52 biliary cystic tumors
53 biliary epithelium
54 carcinoma
55 cases
56 cases of adenocarcinoma
57 cholangiography
58 clinicopathological features
59 communication
60 components
61 conclusion
62 counterparts
63 cystadenocarcinoma
64 cystadenoma
65 cystic dilatation
66 cystic neoplasms
67 cystic tumor
68 cystic variant
69 dilatation
70 disease entity
71 duct
72 entities
73 epithelium
74 evidence
75 excision
76 fashion
77 features
78 females
79 fluid
80 heterogeneous disease entity
81 intraductal papillary mucinous neoplasm
82 intraductal papillary neoplasm
83 intraepithelial neoplasm
84 intraoperative cholangiography
85 luminal communication
86 males
87 mucin retention
88 mucinous carcinoma
89 mucinous epithelium
90 mucinous fluid
91 mucinous neoplasms
92 neoplasms
93 neoplastic biliary epithelium
94 ovarian-like stroma
95 pancreatic intraductal papillary mucinous neoplasms
96 papillary fashion
97 papillary mucinous neoplasm
98 papillary neoplasm
99 recurrence
100 retention
101 situ
102 space
103 stroma
104 study
105 total excision
106 tumor recurrence
107 tumors
108 variants
109 wall
110 years
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