Intraductal papillary neoplasm of the bile duct accompanying biliary mixed adenoneuroendocrine carcinoma

作     者：Ichiro Onishi Hirohisa Kitagawa Kenichi Harada Syogo Maruzen Seisyo Sakai Isamu Makino Hironori Hayashi Hisatoshi Nakagawara Hidehiro Tajima Hiroyuki Takamura Takashi Tani Masato Kayahara Hiroko Ikeda Tetsuo Ohta Yasuni Nakanuma 

作者机构：Department of Gastroenterologic SurgeryGraduate School of Medical ScienceKanazawa UniversityKanazawa 920-8641Japan Department of Human PathologyGraduate School of Medical ScienceKanazawa UniversityKanazawa 920-8650Japan Pathology DivisionKanazawa University HospitalKanazawa 920-8650Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第20期

页      面：3161-3164页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Neuroendocrine tumor Intraductal papillary neoplasm of bile duct Intraductal papillary neoplasm of the bile duct Bile duct 

摘      要：We present the first case of an intraductal papillary neoplasm of the bile duct(IPNB) accompanying a mixed adenoneuroendocrine carcinoma(MANEC).A 74-yearold woman presented with fever of unknown *** data revealed jaundice and liver ***-enhanced computed tomography revealed a 20 mm polypoid tumor in the dilated distal bile duct,which exhibited early enhancement and papillary *** gastrointestinal endoscopy revealed mucus production from the papilla of Vater,characterized by its protruding and dilated *** ultrasonography visualized the polypoid tumor in the distal bile duct,but no invasive region was suggested by diagnostic ***,the initial diagnosis was *** endoscopic nasobiliary drainage,a pylorus-preserving pancreaticoduodenectomy was *** examination of the resected bile duct revealed papillary proliferation of biliary-type cells with nuclear atypia,indicating pancreaticobiliary-type *** addition,solid portions comprised of tumor cells with characteristic salt-and-pepper nuclei were *** revealed expression of the neuroendocrine marker synaptophysin in this solid component,diagnosing it as a neuroendocrine tumor(NET).Furthermore,the MIB-1 proliferation index of NET was higher than that of IPNB,and microinvasion of the NET component was found,indicating neuroendocrine carcinoma(NET G3).This unique case of MANEC,comprising IPNB and NET,provides insight into the pathogenesis of biliary NET.