Intraductal papillary neoplasm of bile duct with invasive carcinoma as an intrahepatic cystic lesion, with successful preoperative diagnosis

2022 ◽  
Vol 15 (1) ◽  
pp. e245918
Author(s):  
Tetsuro Takasaki ◽  
Takashi Sakamoto ◽  
Akira Saito ◽  
Yasuaki Motomura
Keyword(s):  
Bile Duct ◽  
Cystic Lesion ◽  
Invasive Carcinoma ◽  
Pathological Examination ◽  
Mucus Production ◽  
Intraductal Papillary Neoplasm ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Elevated Liver Enzymes ◽  
Papillary Neoplasm

An 82-year-old man presented to the emergency department with abdominal pain and febrile symptoms that had been present for 4 days. Blood tests showed elevated liver enzymes and white blood cell count, and abdominal contrast-enhanced CT revealed a 35 mm cystic lesion in the left lateral liver lobe. On closer examination, the cystic lesion was found to have contiguous bile duct dilatation and internal nodules. Furthermore, mucus production was observed during endoscopic retrograde cholangiopancreatography, which led to the diagnosis of intraductal papillary neoplasm of the bile duct (IPNB), with cystic infection. Although the patient was an older adult, there was no background disease that would have prevented surgery, and resection was performed. Pathological examination revealed type 1 IPNB, with invasive carcinoma. The number of reports of IPNB is expected to increase with an increasing older population in Asia, and we report the findings of this case.

Intraductal papillary neoplasm of bile duct: all rare in one

2020 ◽  
Vol 13 (11) ◽  
pp. e237001
Author(s):  
Aprajita Chaturvedi ◽  
Manjunath Maruti Pol ◽  
Kirti Jangra ◽  
Priyanka Singh
Keyword(s):  
Bile Duct ◽  
Histopathological Examination ◽  
Anatomical Variations ◽  
Small Lesion ◽  
Low Grade ◽  
Pathological Findings ◽  
Intraductal Papillary Neoplasm ◽  
Contrast Enhanced ◽  
Low Grade Dysplasia ◽  
Papillary Neoplasm

A 45-year-old woman was referred from Department of Dermatology to Surgery outpatient department with pruritus since 6 months and an episode of jaundice that lasted for 15 days about 6 months ago. She was referred with a contrast-enhanced MRI finding that showed a small lesion in the lower end of common bile duct. Endoscopy-guided biopsy was performed twice at our hospital, the second revealed low grade dysplasia. Consequently, she underwent pancreaticoduodenectomy. Intraoperatively, there were both vascular and biliary anatomical variations that were missed on preoperative images. On histopathological examination, it turned out to be a mixed variety of intraductal papillary neoplasm of bile duct (IPNB). As all findings were rare in one, hence, we present this case of IPNB that presented to us with variable clinical, radiological, surgical and pathological findings.

scholarly journals Intraductal Papillary Neoplasm of the Bile Duct With Invasive Adenocarcinoma Complicating IgG4-related Sclerosing Cholangitis: Report of a Case

2017 ◽  
Vol 102 (1-2) ◽  
pp. 70-76
Author(s):  
Ryo Ashida ◽  
Teiichi Sugiura ◽  
Yukiyasu Okamura ◽  
Takaaki Ito ◽  
Keiko Sasaki ◽  
...  
Keyword(s):  
Bile Duct ◽  
Sclerosing Cholangitis ◽  
Invasive Carcinoma ◽  
Extrahepatic Bile Duct ◽  
Inflammatory Cells ◽  
Wall Thickening ◽  
Multidetector Row Computed Tomography ◽  
Intraductal Papillary Neoplasm ◽  
Serum Igg4 ◽  
Papillary Neoplasm

Although there have been many previous studies of IgG4-related SC focusing on the differential diagnosis from cholangiocarcinoma, only a few patients with cholangiocarcinoma against a background of IgG4-related SC have been reported. We herein present a case of intraductal papillary neoplasm of the bile duct (IPNB) associated with invasive carcinoma complicating IgG4-related sclerosing cholangitis. A 71-year-old female with icterus was admitted to a local hospital, where stricture of the extrahepatic bile duct were detected, and subsequently referred to our hospital for possible surgery. Abdominal multidetector-row computed tomography demonstrated marked wall thickening along the entire extrahepatic bile duct. The left lateral superior bile duct (B2) and left lateral inferior duct (B3) were individually obstructed, and percutaneous transhepatic biliary drainage catheters were placed in B2 and B3 separately. The patient was diagnosed to have diffusely spread cholangiocarcinoma and underwent right hepatic trisectionectomy with caudate lobectomy and pancreatoduodenectomy. A histological examination revealed intraductal papillary tumors composed of fibrovascular stalks covered by neoplastic epithelium. Carcinomatous invasion of the papillary tumors was observed in the fibromuscular layer, and there was abundant infiltration of inflammatory cells with fibrosis outside of the cancerous tissue. The inflammatory cells were primarily composed of plasma cells, a majority of which were positive for IgG4 (>30 cells/high-power field); the postoperative serum IgG4 level was 890 mg/dL. Therefore, a diagnosis of coexisting IPNB associated with invasive carcinoma and IgG4-related sclerosing cholangitis was made. To the best of our knowledge, this is the first report of IPNB complicating IgG4-related sclerosing cholangitis.

Intraductal papillary neoplasm of the bile duct with infiltrative small cell neuroendocrine carcinoma: A case report

2021 ◽  
Author(s):  
Baoyi Zhao ◽  
Hua-jun Lin ◽  
Wen-hao Man ◽  
Cai-li Su ◽  
Zhong-tao Zhang ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Neuroendocrine Carcinoma ◽  
Clinical Manifestations ◽  
Chinese Patient ◽  
Small Cell ◽  
Pathological Examination ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Intraductal Papillary Neoplasm ◽  
Papillary Neoplasm

Abstract Introduction: We present the case of an intraductal papillary neoplasm of the bile duct (IPNB) accompanying a small cell neuroendocrine carcinoma. Patient concerns: A 73-year-old male Chinese patient presented with jaundice of unknown origin. A contrast-enhanced computed tomography scan revealed that the wall of the lower common bile duct was thickened and nodular, causing a narrowing in the lumen and upper common bile duct enlargement above the narrow segment. Diagnosis and interventions: The initial diagnosis based on clinical manifestations was IPNB and pancreatoduodenectomy was performed. Pathological examination of the resected bile duct revealed papillary proliferation of biliary-type cells with nuclear atypia, indicating IPNB. Immunohistochemistry was positive for neuroendocrine markers indicative of infiltration and small cell neuroendocrine cancer. Outcomes: The patient died on postoperative day 138. Conclusion: This is the first reported case of its kind, as none has been reported in any published literature so far.

Intraductal papillary neoplasm of the bile duct: Assessment of invasive carcinoma and long-term outcomes using MRI

2019 ◽  
Vol 70 (4) ◽  
pp. 692-699 ◽  
Author(s):  
Sunyoung Lee ◽  
Myeong-Jin Kim ◽  
Sohee Kim ◽  
Dongil Choi ◽  
Kee-Taek Jang ◽  
...  
Keyword(s):  
Bile Duct ◽  
Invasive Carcinoma ◽  
Long Term Outcomes ◽  
Intraductal Papillary Neoplasm ◽  
Papillary Neoplasm

scholarly journals A case of hepatic intraductal papillary neoplasm of the bile duct

2021 ◽  
Author(s):  
Eisuke Mukaida ◽  
Akio Tamura ◽  
Kunihiro Yoshioka ◽  
Masao Nishiya ◽  
Tamotsu Sugai
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bile Duct ◽  
Invasive Carcinoma ◽  
Pathological Findings ◽  
Resonance Imaging ◽  
Intraductal Papillary Neoplasm ◽  
History Of ◽  
Right Lobe ◽  
The Right ◽  
Papillary Neoplasm

In this report, we present a 57-year-old female with a history of mild alcoholic liver disease during a medical check-up. Abdominal computed tomography and magnetic resonance imaging showed a multicystic mass with a solid enhancing mural nodule in the right lobe of the liver. Subsequently, laparoscopic right liver lobectomy was performed and pathological findings revealed intraductal papillary neoplasm of the bile duct (IPNB) with an associated invasive carcinoma. IPNB is a relatively rare disease that should be considered in the differential diagnosis of hepatic cystic tumours. Our case report highlights the importance of capturing image findings of the IPNB as this disease has a high potential for malignancy.

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