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World Journal of Gastroenterology 2014年第42期20卷 15925-15930页

作者： Hiroyuki Hachiya Junji Kita Takayuki Shiraki Yukihiro Iso Mitsugi Shimoda Keiichi Kubota Second Department of Surgery Dokkyo Medical University

We report a case of intraductal papillary neoplasm of the bile duct(IPNB) that developed in a patient with primary sclerosing cholangitis. A 46-year-old woman was admitted to our hospital with obstructive jaundice. The liver function tests demonstrated increased serum liver enzyme levels. Computed tomography showed dilatation of the intrahepatic bile ducts. Abdominal ultrasonography revealed a highly echoic protruding lesion in the posterior bile duct near the right lobe of the liver. The lesion was suspected to be IPNB, but we were unable to confirm whether it was a carcinoma. A right hepatectomy was performed, and this showed that the dilated bile duct was filled with mucin and contained several yellowish papillary tumors. Histologically, the neoplastic biliary epithelium showed papillary growth in the dilated lumen. The tumor was diagnosed as IPNB, high-grade intraepithelial neoplasia secreting abundant mucin. No recurrence has been detected 3 years after surgery.

关键词： intraductal papillary neoplasm of the bile duct Primary sclerosing cholangitis Cholangiocarcinoma High-grade intraepithelial neoplasia Premalignant lesion

Current status of diagnosis and therapy for intraductal papillary neoplasm of the bile duct

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World Journal of Gastroenterology 2021年第15期27卷 1569-1577页

作者： Yuji Sakai Masayuki Ohtsuka Harutoshi Sugiyama Rintaro Mikata Shin Yasui Izumi Ohno Yotaro Iino Jun Kato Toshio Tsuyuguchi Naoya Kato Department of Gastroenterology and Nephrology Graduate School of MedicineChiba UniversityChiba 260-8670Japan Department of General Surgery Graduate School of MedicineChiba UniversityChiba 260-8670Japan

bile duct epithelial tumours showing papillary neoplasm in the bile duct lumen are present in the intrahepatic and extrahepatic bile *** images of these tumours are distinctive and diverse,including histological images with a low to high grade dysplasia,infiltrating and noninfiltrating characteristics,excessive mucus production,and similarity to intraductal papillary mucinous neoplasm(IPMN)of the *** World Health Organization Classification of Tumours of the Digestive System in 2010 named these features,intraductal papillary neoplasm of the bile duct(IPNB),as precancerous lesion of biliary *** is currently classified into type 1 that is similar to IPMN,and type 2 that is not similar to *** of IPNB spreads superficially,and diagnosis with cholangioscopy is considered mandatory to identify accurate localization and *** of IPNB is said to be better than normal bile duct cancer.

关键词： intraductal papillary neoplasm of the bile duct intraductal papillary mucinous neoplasm of the pancreas Peroral cholangioscopy Cholangioscopy

Unexpected metastasis of intraductal papillary neoplasm of the bile duct without an invasive component to the brain and lungs:A case report

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World Journal of Gastroenterology 2020年第3期26卷 366-374页

作者： Nguyen Hai Nam Kojiro Taura Masashi Kanai Keita Fukuyama Norimitsu Uza Hirona Maeda Yojiro Yutaka Toyofumi F Chen-Yoshikawa Manabu Muto Shinji Uemoto Division of Hepato-Biliary-Pancreatic Surgery and Transplantation Department of SurgeryGraduate School of MedicineKyoto UniversityKyoto 606-8501Japan Department of Clinical Oncology Pharmacogenomicsand Palliative MedicineGraduate School of MedicineKyoto UniversityKyoto 606-8507Japan Department of Gastroenterology and Hepatology Graduate School of MedicineKyoto UniversityKyoto 606-8507Japan Department of Diagnostic Pathology Kyoto University HospitalKyoto 606-8507Japan Toyofumi F Chen-Yoshikawa Department of Thoracic.SurgeryGraduate School of MedicineKyoto UniversityKyoto 606-8507Japan Department of Therapeutic Oncology Graduate School of MedicineKyoto UniversityKyoto 606-8507Japan

BACKGROUND Despite an expanding number of studies on intraductal papillary neoplasm of the bile duct(IPNB),distant metastasis remains unexplained especially in cases of carcinoma in *** the present study,we report a rare and interesting case of IPNB without invasive components that later metastasized to lungs and *** SUMMARY A 69-year-old male was referred to our hospital due to suspected *** tests on admission reported a mild elevation of alkaline phosphatase,γ-glutamyl transpeptidase,and total bilirubin in *** retrograde cholangiography revealed a filling defect in the common bile duct(CBD)extending to the left hepatic *** cholangioscopy delineated a tumor in the CBD that had a papillary *** computed tomography and magnetic resonance cholangiopancreatography detected partial blockage ot interlude in the CBD leading to cholestasis without evidence of ***,a diagnosis of IPNB cT1N0M0 was *** hepatectomy with bile duct reconstruction was *** examination confirmed an intraepithelial neoplasia pattern without an invasive component and an R0 resection *** patient was monitored carefully by regular ***,at 32 mo after the operation,a 26 mm tumor in the lungs and a 12 mm lesion in the brain were detected following a suspicious elevated CA 19-9 ***-assisted thoracoscopic surgery of left upper lobectomy and stereotactic radiotherapy are *** addition to histopathological results,a genomic profiling analysis using whole exome sequencing subsequently confirmed lung metastasis originating from bile duct *** This case highlights the important role of genomic profiling analysis using whole exome sequencing in identifying the origin of metastasis in patients with IPNB.

关键词： intraductal papillary neoplasm of the bile duct Distant metastasis Invasive component Whole exome sequencing CA 19-9 Case report

Percutaneous transhepatic cholangioscopy-assisted biliary polypectomy for local palliative treatment of intraductal papillary neoplasm of the bile duct

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 1821-1832页

作者： Xu Ren Yong-Ping Qu Chun-Lan Zhu Xiao-Hong Xu Hong Jiang Yi-Xia Lu Hong-Peng Xue Digestive Disease Hospital of Heilongjiang Provincial Hospital Heilongjiang Provincial Clinical Medical Research Center for Minimally Invasive Diagnosis and Treatment of Pancreaticobiliary DiseasesHarbin 150001Heilongjiang ProvinceChina Digestive Endoscopy Center of Heilongjiang Provincial Hospital Heilongjiang Provincial Clinical Medical Research Center for Minimally Invasive Diagnosis and Treatment of Pancreaticobiliary DiseasesHarbin 150001Heilongjiang ProvinceChina Second Department of Gastroenterology Digestive Disease Hospital of Heilongjiang Provincial Hospitaland Heilongjiang Provincial Clinical Medical Research Center for Minimally Invasive Diagnosis and Treatment of Pancreaticobiliary DiseasesHarbin 150001Heilongjiang ProvinceChina Department of Pathology Heilongjiang Provincial HospitalHarbin 150001Heilongjiang ProvinceChina

BACKGROUND intraductal papillary neoplasm of the bile duct(IPNB)is a premalignant biliarytype epithelial neoplasm with intraductal papillary or villous *** reported local palliative therapeutic modalities,including endoscopic nasobiliary drainage,stenting and biliary curettage,endoscopic biliary polypectomy,percutaneous biliary drainage,laser ablation,argon plasma coagulation,photodynamic therapy,and radiofrequency ablation to relieve mechanical obstruction are limited with weaknesses and *** have applied percutaneous transhepatic cholangioscopy(PTCS)-assisted biliary polypectomy(PTCS-BP)technique for the management of IPNB including mucin-hypersecreting cast-like and polypoid type tumors since *** To assess the technical feasibility,efficacy,and safety of PTCS-BP for local palliative treatment of *** Patients with mucin-hypersecreting cast-like or polypoid type IPNB and receiving PTCS-BP between September 2010 and December 2019 were ***-BP was performed by using a half-moon type snare with a soft stainless-steel wire,and the tumor was snared and resected with *** primary outcome was its feasibility,indicated by technical *** secondary outcomes were efficacy,including therapeutic success,curative resection,and clinical success,and *** Five patients(four with mucin-hypersecreting cast-like type and one with polypoid type IPNB)were ***-and high-grade intraepithelial neoplasia(HGIN)and recurrent IPNB with invasive carcinoma were observed in one,two,and two patients,*** cholangitis and/or obstructive jaundice were presented in all four patients with mucin-hypersecreting cast-like type *** five patients achieved technical success of *** patients(three with mucin-hypersecreting cast-like type and one with polypoid type IPNB)obtained therapeutic success;one with mucin-hypersecreting cast-like type tumors in the intrahepatic small bile duct and HGIN h

关键词： intraductal papillary neoplasm of the bile duct Percutaneous transhepatic cholangioscopy Biliary polypectomy Feasibility Efficacy

Surgically treating a rare and asymptomatic intraductal papillary neoplasm of the bile duct:A case report

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World Journal of Clinical Cases 2024年第2期12卷 367-373页

作者： Shen-Zhen Zhu Zhao-Feng Gao Xiao-Rong Liu Xiao-Guang Wang Fei Chen Department of General Surgery Jiaxing Second HospitalJiaxing 314000Zhejiang ProvinceChina Department of Hepatobiliary Surgery Jiaxing Second HospitalJiaxing 314000Zhejiang ProvinceChina

BACKGROUND intraductal papillary neoplasms of the bile duct(IPNBs)are rare and characterized by papillary growth within the bile duct *** is similar to obstructive biliary *** this report,we present an unexpected case of asymptomatic IPNB and consolidate our findings with the relevant literature to augment our understanding of this *** relevant literature contributes to a more comprehensive understanding of the *** SUMMARY A 66-year-old Chinese male patient was admitted to our hospital for surgical intervention after gallstones were discovered during a routine physical *** imaging revealed a lesion on the left side of the liver,which raised the suspicion of IPNB.A laparoscopic left hemihepatectomy was performed,and subsequent histopathological examination confirmed the diagnosis of *** the 3-mo postoperative follow-up,the patient reported good recovery and no *** can manifest both latently and *** surgical resection is the most effective treatment for *** Hepatic and biliary masses,should be considered to diagnose *** surgery and vigilant follow-up are crucial in determining prognosis.

关键词： intraductal papillary neoplasm of the bile duct Tumor Surgical treatment Prognosis Case report

Reoperation for heterochronic intraductal papillary mucinous neoplasm of the pancreas after bile duct neoplasm resection:A case report

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World Journal of Gastrointestinal Surgery 2023年第7期15卷 1542-1548页

作者： Gang Xiao Tao Xia Yi-Ping Mou Yu-Cheng Zhou Department of Hepatopancreatobiliary Surgery Shaoxing People’s HospitalShaoxing 312000Zhejiang ProvinceChina Division of Gastrointestinal and Pancreatic Surgery Department of General SurgeryZhejiang Provincial People’s Hospital(People’s Hospital of Hangzhou Medical College)Key Laboratory of Gastroenterology of Zhejiang ProvinceHangzhou 310014Zhejiang ProvinceChina

BACKGROUND intraductal papillary neoplasm of the bile duct(IPNB)and intraductal papillary mucinous neoplasm(IPMN)of the pancreas have similar pathological ***,they often develop separately and it is rare for both to occur *** presenting with heterochronic IPMN after IPNB are prone to be misdiagnosed with tumor *** SUMMARY A 67-year-old male patient was admitted 8.5 years after IPNB carcinoma and 4 years after the discovery of a pancreatic tumor.A left hepatic bile duct tumor with distal bile duct dilatation was found 8.5 years ago by the computed tomography;therefore,a left hepatectomy was *** postoperative pathological diagnosis was malignant IPNB with negative cutting edge and pathological stage *** resonance imaging 4 years ago showed cystic lesions in the pancreatic head with pancreatic duct dilatation,and carcinoembryonic antigen continued to *** emission tomography showed a maximum standard uptake value of 11.8 in the soft tissue mass in the pancreatic head,and a malignant tumor was *** pancreatoduodenectomy was *** pathological diagnosis was pancreatic head IPMN with negative cutting edge,pancreaticobiliary type,stage *** was discharged 15 d after the ***-up for 6 mo showed no tumor recurrence,and quality of life was *** IPNB and IPMN are precancerous lesions with similar pathological characteristics and require active surgery and long-term follow-up.

关键词： intraductal papillary neoplasm of the bile duct intraductal papillary mucinous neoplasm of the pancreas Pancreatoduodenectomy Heterochronous tumor Reoperation Case report

A Review of Type 1 and Type 2 intraductal papillary neoplasms of the bile duct

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Current Medical Science 2024年第3期44卷 485-493页

作者： Xia-hui HUANG Tian-xiang CHEN Hong-liang LIU Ming-wen HUANG Department of General Surgery The Second Affiliated Hospital of Nanchang UniversityNanchang330006China

intraductal papillary neoplasm of the bile duct(IPNB)is a heterogeneous disease similar to intraductal papillary mucinous neoplasm of the *** lesions have been recognized as one of the three major precancerous lesions in the biliary tract since *** 2018,Japanese and Korean pathologists reached a consensus,classifying IPNBs into type l and type 2 *** are more prevalent in male patients in East Asia and are closely related to diseases such as cholelithiasis and *** a molecular genetic perspective,IPNBs exhibit early genetic variations,and different molecular pathways may be involved in the tumorigenesis of type 1 and type 2 *** histological subtypes of IPNBs include gastric,intestinal,pancreaticobiliary,or oncocytic subtypes,but type 1 IPNBs typically exhibit more regular and well-organized histological features than type 2 IPNBs and are more commonly found in the intrahepatic bile ducts with abundant *** to the rarity of these lesions and the absence of specific clinical and laboratory features,imaging is crucial for the preoperative diagnosis of IPNB,with local bile duct dilation and growth along the bile ducts being the main imaging *** resection remains the optimal treatment for IPNBs,but negative bile duct margins and the removal of lymph nodes in the hepatic hilum significantly improve the postoperative survival rates for patients with IPNBs.

关键词： intraductal papillary neoplasm of the bile duct subclassification neoplasms precancerous tissue prognosis

intraductal neoplasm of the intrahepatic bile duct: Clinicopathological study of 24 cases

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World Journal of Gastroenterology 2012年第28期18卷 3673-3680页

作者： Yoshiki Naito Hironori Kusano Osamu Nakashima Eiji Sadashima Satoshi Hattori Tomoki Taira Akihiko Kawahara Yoshinobu Okabe Kazuhide Shimamatsu Jun Taguchi Seiya Momosaki Koji Irie Rin Yamaguchi Hiroshi Yokomizo Michiko Nagamine Seiji Fukuda Shinichi Sugiyama Naoyo Nishida Koichi Higaki Munehiro Yoshitomi Masafumi Yasunaga Koji Okuda Hisafumi Kinoshita Masayoshi Kage Masamichi Nakayama Makiko Yasumoto Jun Akiba Hirohisa Yano Departments of Pathology Kurume University School of Medicine Kurume 830-0011 Japan Biostatistics Center Kurume University Kurume 830-0011 Japan Department of Diagnostic Pathology Kurume University Hospital Kurume 830-0011 Japan Division of Gastroenterology Department of Medicine Kurume University School of Medicine Kurume 830-0011 Japan Department of Pathology Omuta City General Hospital Omuta 836-8567 Japan Department of Pathology Asakura Medical Association Hospital Fukuoka 838-0069 Japan Department of Pathology National Hospital Organization Kyushu Medical Center Fukuoka 810-8563 Japan Department of Pathology Shin-Koga Hospital Tenjinkai 120 Tenjincho Kurume 830-0033 Japan Department of Pathology Kurume University Medical Center 155-1 Kokubumachi Kurume 839-0863 Japan Department of Surgery Japanese Red Cross Kumamoto Hospital Kumamoto 861-8520 Japan Department of Pathology Japanese Red Cross Kumamoto Hospital Kumamoto 861-8520 Japan Division of Surgery Saiseikai Kumamoto Hospital Kumamoto 861-4193 Japan Department of Pathology St Mary's Hospital Kurume 830-8543 Japan Department of Surgery Kurume University School of Medicine Kurume 830-0011 Japan

AIM: To investigate the clinicopathological features of intraductal neoplasm of the intrahepatic bile duct (INihB). METHODS: Clinicopathological features of 24 cases of INihB, which were previously diagnosed as biliary papillomatosis or intraductal growth of intrahepatic biliary neoplasm, were reviewed. Mucin immunohistochemistry was performed for mucin (MUC)1, MUC2, MUC5AC and MUC6. Ki-67, P53 and β-catenin immunoreactivity were also examined. We categorized each tumor as adenoma (low grade), borderline (intermediate grade), and malignant (carcinoma in situ , high grade including tumors with microinvasion). RESULTS: Among 24 cases of INihB, we identified 24 tumors. Twenty of 24 tumors (83%) were composed of a papillary structure; the same feature observed in intraductal papillary neoplasm of the bile duct (IPNB). In contrast, the remaining four tumors (17%) showed both tubular and papillary structures. In three of the four tumors (75%), macroscopic mucin secretion was limited but microscopic intracellular mucin was evident. Histologically, 16 tumors (67%) were malignant, three (12%) were borderline, and five (21%) were adenoma. Microinvasion was found in four cases (17%). Immunohistochemical analysis revealed that MUC1 was not expressed in the borderline/adenoma group but was expressed only in malignant lesions (P = 0.0095). Ki-67 labeling index (LI) was significantly higher in the malignant group than in the borderline/adenoma group (22.2 ± 15.5 vs 7.5 ± 6.3, P < 0.01). In the 16 malignant cases, expression of MUC5AC showed borderline significant association with high Ki-67 LI (P = 0.0622). Nuclear expression of β-catenin was observed in two (8%) of the 24 tumors, and these two tumors also showed MUC1 expression. P53 was negative in all tumors. CONCLUSION: Some cases of INihB have a tubular structure, and are subcategorized as IPNB with tubular structure. MUC1 expression in INihB correlates positively with degree of malignancy.

关键词： intraductal biliary neoplasm intraductal papillary neoplasm of the bile duct intraductal tubular neoplasm of the bile duct intraductal tubulopapillary neoplasm of the bile duct Mucin expression