Updates on Precancerous Lesions of the Biliary Tract: Biliary Precancerous Lesion

2016 ◽  
Vol 140 (11) ◽  
pp. 1285-1289 ◽  
Author(s):  
Sanaz Ainechi ◽  
Hwajeong Lee
Keyword(s):  
Bile Duct ◽  
Biliary Tract ◽  
Precancerous Lesions ◽  
Precancerous Lesion ◽  
Intraepithelial Neoplasia ◽  
Precursor Lesions ◽  
Invasive Adenocarcinoma ◽  
Intraductal Papillary Neoplasm ◽  
Pathologic Features ◽  
Mechanisms Of Carcinogenesis

Precursor lesions of invasive adenocarcinoma of the bile duct (cholangiocarcinoma) have been increasingly recognized during the past decade because of the results of multiple studies on the carcinogenesis of cholangiocarcinoma, technologic advancements in diagnostic imaging modalities, and an increase in the volume of elective procedures. The two main precursor lesions of cholangiocarcinoma that have evolved are biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct. These lesions demonstrate histomorphologic similarities to pancreatic intraepithelial neoplasia and intraductal papillary mucinous neoplasm of the pancreas, respectively, whereas mechanisms of carcinogenesis and risk of progressive disease appear distinct. An enhanced understanding of the clinical presentation and pathologic features of precursor lesions of the biliary tract and use of the correct terminology will facilitate efficient communication between surgeons, oncologists, and pathologists and improve quality of patient care.

scholarly journals Intraductal Papillary Neoplasms of the Bile Duct

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Masayuki Ohtsuka ◽  
Hiroaki Shimizu ◽  
Atsushi Kato ◽  
Hideyuki Yoshitomi ◽  
Katsunori Furukawa ◽  
...  
Keyword(s):  
Bile Duct ◽  
Molecular Genetic ◽  
Intraepithelial Neoplasia ◽  
Mucinous Carcinoma ◽  
Tumor Location ◽  
Tubular Adenocarcinoma ◽  
Superficial Spreading ◽  
Genetic Changes ◽  
Intraductal Papillary Neoplasm ◽  
Radiologic Findings

Intraductal papillary neoplasm of the bile duct (IPNB) is a rare variant of bile duct tumors characterized by papillary growth within the bile duct lumen and is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm of the pancreas. IPNBs display a spectrum of premalignant lesion towards invasive cholangiocarcinoma. The most common radiologic findings for IPNB are bile duct dilatation and intraductal masses. The major treatment of IPNB is surgical resection. Ultrasonography, computed tomography, magnetic resonance image, and cholangiography are usually performed to assess tumor location and extension. Cholangioscopy can confirm the histology and assess the extent of the tumor including superficial spreading along the biliary epithelium. However, pathologic diagnosis by preoperative biopsy cannot always reflect the maximum degree of atypia, because IPNBs are often composed of varying degrees of cytoarchitectural atypia. IPNBs are microscopically classified into four epithelial subtypes, such as pancreatobiliary, intestinal, gastric, and oncocytic types. Most cases of IPNB are IPN with high-grade intraepithelial neoplasia or with an associated invasive carcinoma. The histologic types of invasive lesions are either tubular adenocarcinoma or mucinous carcinoma. Although several authors have investigated molecular genetic changes during the development and progression of IPNB, these are still poorly characterized and controversial.

scholarly journals What Are the Precursor and Early Lesions of Peripheral Intrahepatic Cholangiocarcinoma?

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Yasuni Nakanuma ◽  
Akemi Tsutsui ◽  
Xiang Shan Ren ◽  
Kenichi Harada ◽  
Yasunori Sato ◽  
...  
Keyword(s):  
Bile Duct ◽  
Bile Ducts ◽  
Precursor Lesions ◽  
Intraductal Papillary Neoplasm ◽  
Combined Hepatocellular Cholangiocarcinoma ◽  
Biliary Adenofibroma ◽  
Bile Duct Lesions ◽  
Large Bile Duct ◽  
Papillary Neoplasm ◽  
Bile Duct Adenoma

Cholangiocarcinoma (CC) is divided into distal, perihilar, and intrahepatic CCs (ICCS), and are further subdivided into large bile duct ICC and peripheral ICC. In distal and perihilar CC and large duct ICC, biliary intraepithelial neoplasm (BilIN) and intraductal papillary neoplasm (IPN) have been proposed as precursor lesions. Peripheral ICC, bile duct adenoma (BDA), biliary adenofibroma (BAF), and von Meyenburg complexes (VMCs) are reportedly followed by development of ICCs. Herein, we surveyed these candidate precursor lesions in the background liver of 37 cases of peripheral ICC and controls (perihilar CC, 34 cases; hepatocellular carcinoma, 34 cases and combined hepatocellular cholangiocarcinoma, 25 cases). In the background liver of peripheral ICC, BDA and BAF were not found, but there were not infrequently foci of BDA-like lesions and atypical bile duct lesions involving small bile ducts (32.4% and 10.8%, resp.). VMCs were equally found in peripheral CCs and also control CCs. In conclusion, BDA, BAF, and VMCs are a possible precursor lesion of a minority of peripheral CCs, and BDA-like lesions and atypical bile duct lesions involving small bile ducts may also be related to the development of peripheral ICC. Further pathologic studies on these lesions are warranted for analysis of development of peripheral ICCs.

Identifying early cancer of the uterine cervix - a look at the precursor lesions: literature integrative review

2011 ◽  
Vol 5 (3) ◽  
pp. 812
Author(s):  
Rosana Oliveira Melo ◽  
Regina Mendonça Lopes ◽  
Rita Rocha Moreira
Keyword(s):  
Early Diagnosis ◽  
Uterine Cervix ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Service Access ◽  
Precursor Lesions ◽  
Treatment Access ◽  
Calidad De Vida ◽  
Factores De Riesgo ◽  
Las Mujeres

ABSTRACTObjective: presenting a literature review reflects on the prevention of precursor lesions for cancer of the uterine cervix. Method: this is about a literature integrative study. Were used in this review: books (6), summaries of theses (5) and thesis (1) articles (7), as well as national and international publications in terms of health print and online. These materials were read and analyzed between April 2009 and July 2010. Results: upon reading and cataloging the data were organized into analytical categories: identification of risk factors, prevention, early diagnosis and appropriate treatment, access to services, recognition of the subjectivity of women with precancerous lesions of the cervix. Conclusion: this study allowed reflection on the diagnosis and treatment of precursor lesions demonstrating the importance of a closer look at prevention in order to improve service access, dialogue with health professionals, as well as the quality of life and longevity of women with these lesions. Descriptors: nursing; women's health; cervix neoplasms prevention; cervical intraepithelial neoplasia;  early diagnosis.  RESUMOObjetivo: apresentar revisão da literatura sobre a importância do diagnóstico precoce das lesões precursoras para prevenção do câncer do colo do útero. Método: utilizou- se a pesquisa bibliográfica. Foram utilizados nesta revisão: livros (6), resumos de dissertações (5) e tese (1), artigos (7), além de publicações nacionais e internacionais da saúde nas modalidades impressa e online. Estes materiais foram lidos e analisados entre abril de 2009 a julho de 2010. Resultados: após a catalogação e leitura, os dados encontrados foram organizados em eixos analíticos: identificação dos fatores de risco, a prevenção, diagnóstico precoce e tratamento adequado, acesso aos serviços, valorização da subjetividade das mulheres com lesões precursoras de câncer do colo do útero. Conclusão: este estudo permitiu reflexões sobre o diagnóstico e a terapêutica das lesões precursoras demonstrando a relevância de um olhar atento para a prevenção na perspectiva de melhorar o acesso ao serviço, o diálogo com os profissionais de saúde, bem como, a qualidade de vida e longevidade das mulheres portadoras destas lesões.      Descritores: enfermagem; saúde da mulher; prevenção de câncer de colo uterino; neoplasia intra-epitelial cervical; diagnóstico precoce. RESUMEN Objetivo: presentar una revisión de la literatura con el objetivo reflexionar sobre la prevención de las lesiones precursoras de cáncer de cuello uterino. Método: se utilizó la búsqueda bibliográfica. Se utilizaron en esta revisión: los libros (6), resúmenes de tesis (5) y la tesis (1) artículos (7), así como publicaciones nacionales e internacionales en materia de salud y de impresión en línea. Estos materiales fueron leídos y analizados entre abril de 2009 y julio de 2010. Resultados: Al momento de la lectura y la catalogación de los datos fueron organizados en    categorías de análisis: la identificación de factores de riesgo, prevención, diagnóstico precoz y un tratamiento adecuado, el acceso a los servicios, el reconocimiento de la subjetividad de las mujeres con lesiones precancerosas del cuello uterino. Conclusión: este estudio permitió la reflexión sobre el diagnóstico y tratamiento de lesiones precursoras que demuestra la importancia de una mirada más cercana a la prevención con el fin de mejorar el acceso de servicio, el diálogo con los profesionales de la salud, así como la calidad de vida y longevidad de las mujeres con estas lesiones. Descriptores: enfermería, salud de la mujer; prevención de cáncer de cuello uterino; neoplasia intraepitelial del cuello uterino;  diagnóstico precoz.  

Intraductal Papillary Neoplasm of the Bile Duct: Clinical, Imaging, and Pathologic Features

2018 ◽  
Vol 211 (1) ◽  
pp. 67-75 ◽  
Author(s):  
Hyo Jung Park ◽  
So Yeon Kim ◽  
Hyoung Jung Kim ◽  
Seung Soo Lee ◽  
Gil Sun Hong ◽  
...  
Keyword(s):  
Bile Duct ◽  
Clinical Imaging ◽  
Intraductal Papillary Neoplasm ◽  
Pathologic Features ◽  
Papillary Neoplasm

scholarly journals Tumor Infiltrating Neutrophils Are Frequently Found in Adenocarcinomas of the Biliary Tract and Their Precursor Lesions with Possible Impact on Prognosis

2021 ◽  
Vol 11 (3) ◽  
pp. 233
Author(s):  
Vittorio Branchi ◽  
Benedict Jürgensen ◽  
Laura Esser ◽  
Maria Gonzalez-Carmona ◽  
Tobias J. Weismüller ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Immune Cell ◽  
Malignant Tumors ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Clinical Role ◽  
Tissue Samples ◽  
Tract Cancer ◽  
Prognostic Relevance ◽  
Complex Landscape

Biliary tract cancer (BTC) is characterized by an intense stromal reaction and a complex landscape of infiltrating immune cells. Evidence is emerging that tumor-infiltrating neutrophils (TINs) have an impact on carcinogenesis and tumor progression. TINs have also been associated with outcomes in various solid malignant tumors but their possible clinical role in BTC is largely unknown. Tissue samples from patients with sporadic BTC (“spBTC” cohort, N = 53) and BTC in association with primary sclerosing cholangitis (“PSC-BTC” cohort, N = 7) were collected. Furthermore, tissue samples from 27 patients with PSC who underwent liver transplantation (“PSC-LTX” cohort) were investigated. All specimens were assessed for TIN density in invasive and precancerous lesions (biliary intraepithelial neoplasia, BilIN). Most spBTC showed low TIN density (LD, 61%). High TIN density (HD) was detected in 16% of the tumors, whereas 23% were classified as intermediate density (ID); the majority of both HD and ID groups were in T1–T2 tumors (83% and 100%, p = 0.012). TIN density in BilIN lesions did not significantly differ among the three groups. The HD group had a mean overall survival (OS) of 53.5 months, whereas the mean OS in the LD and ID groups was significantly shorter (LD 29.5 months vs. ID 24.6 months, log-rank p < 0.05). The results of this study underline the possible prognostic relevance of TINs in BTC and stress the complexity of the immune cell landscape in BTC. The prognostic relevance of TINs suggests a key regulator role in inflammation and immune landscape in BTC.

scholarly journals Intraductal papillary neoplasm of extrahepatic biliary tract with an associated early invasive adenocarcinoma

2014 ◽  
Vol 3 ◽  
pp. 1
Author(s):  
Jayathilaka Karunanayake Hiroshi ◽  
Siriwardhana Rohan ◽  
Nawaratne NMM ◽  
Mahendra Gayana ◽  
Liyanage Chandika
Keyword(s):  
Biliary Tract ◽  
Invasive Adenocarcinoma ◽  
Intraductal Papillary Neoplasm ◽  
Papillary Neoplasm

Tumors of the Biliary Tract

2019 ◽  
Author(s):  
Alex C Kim ◽  
Hari Nathan
Keyword(s):  
Biliary Tract ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Intraepithelial Neoplasia ◽  
Percutaneous Transhepatic Cholangiography ◽  
Intraductal Papillary Neoplasm ◽  
American Joint Committee ◽  
Staging Systems ◽  
Malignant Lesions

Biliary tract tumors are derived from the underlying intrahepatic or extrahepatic biliary epithelium. Molecular analysis of the biliary neoplasms suggests a stepwise tumor progression from benign to malignant lesions. Treatment of these tumors remains complex and requires a careful clinical evaluation. Revisions of staging systems allow for appropriate evaluation of the extent of the malignancy. Refined surgical techniques and advances in adjuvant therapies provide improved treatment options. Despite these efforts, the prognosis remains poor. This chapter discusses several different types of biliary tumors, including the gallbladder carcinoma, and examines the underlying etiologies, clinical presentation, diagnostic studies, staging, treatment, and prognosis. The staging of the malignant lesions is updated to reflect the American Joint Committee on Cancer’s eighth edition system. This review contains 7 figures, 5 tables, and 77 references. Key Words: α-fetoprotein, American Joint Committee on Cancer, biliary intraepithelial neoplasia, Bismuth-Corlette, CA19-9, cystadenoma, endoscopic retrograde cholangiopancreatography, intraductal papillary neoplasm of the bile duct, Magnetic resonance cholangiopancreatography, primary sclerosing cholangitis, percutaneous transhepatic cholangiography

scholarly journals Precursor Lesions of Cholangiocarcinoma: A Clinicopathologic Review

2020 ◽  
Vol 13 ◽  
pp. 2632010X2092504
Author(s):  
Bita Geramizadeh
Keyword(s):  
Intraepithelial Neoplasia ◽  
Precursor Lesions ◽  
Multistep Carcinogenesis ◽  
Biliary Intraepithelial Neoplasia ◽  
The Past ◽  
Intraductal Papillary Neoplasm ◽  
Life Threatening ◽  
Papillary Neoplasm ◽  
Pathological Manifestation

Cholangiocarcinoma (CCA) develops through multistep carcinogenesis. During the past decades, 2 precursors have been proved to evolve to CCA. The 2 main precursor lesions of CCA are biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct. It is an interesting and relatively novel entity for the hepatobiliary surgeons, radiologists, oncologists, and pathologists. It worth being familiar with these 2 entities for better communication between pathologists, oncologists, and surgeons to improve the treatment and follow-up of these lesions, which can definitely decrease their evolvement to CCA as an aggressive, poor prognostic, and life-threatening cancer. In this narrative review, I collected and discussed all published studies about these 2 precursor lesions of CCA including radiologic, clinical, and pathological manifestation.

scholarly journals Precursors to Cholangiocarcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Tomas Hucl
Keyword(s):  
Bile Duct ◽  
Natural History ◽  
Biliary Tract ◽  
Intraepithelial Neoplasia ◽  
Mucinous Cystic Neoplasm ◽  
Cystic Neoplasm ◽  
Biliary Tract Cancers ◽  
Biliary Intraepithelial Neoplasia ◽  
Prevention And Early Detection ◽  
Duct Cancer

Cancers of the biliary tract include intra- and extrahepatic cholangiocarcinomas and gallbladder cancer. Biliary tract cancers are diseases with unfavorable prognoses. In recent years, several lesions have been described as precursors that precede biliary cancers. They include flat and microscopic lesions known as biliary intraepithelial neoplasia, macroscopic and tumor-forming intraductal papillary biliary neoplasia, intraductal tubular neoplasia, and mucinous cystic neoplasm of the bile duct. These conditions are rarely diagnosed, while their natural history and progression to cancer have yet to be adequately characterized. This review examines the epidemiology, pathology, molecular biology, diagnosis, and therapy of these various precursors. Further research is required if we are to better understand this evolving field and improve the prevention and early detection of bile duct cancer.

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