A Patient Who Was Diagnosed As IPN-B Without Hepatolithiasis?

Main Category: GastroIntestinal / Gastroenterology
Also Included In: Cancer / Oncology
Article Date: 04 May 2008 - 2:00 PDT

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Intraductal papillary neoplasm of the bile duct (IPN-B) is a neoplastic lesion preceding invasive intrahepatic cholangiocarcinoma (ICC) and is a new definition of a tumor with papillary growth in the intra- or extra-hepatic bile duct. The authors reported a case of IPN-B with interesting histopathological findings and emphasized that cholangiography is especially helpful for the diagnosis of bile duct dilatation due to the infiltration of carcinoma cells.

This case report, presented by a group led by Dr J Hayashi, is described in a research article to be published on March 14, 2008, in the World Journal of Gastroenterology.

This patient's laboratory data were within normal ranges and no solid mass was detected in her abdominal computed tomography (CT) scan or nuclear magnetic resonance imaging (MRI). However, endoscopic retrograde cholangiopancreatography (ERCP) demonstrated an obstruction of the right bile duct. ERCP is recommended to determine the presence and location of the suspected intraductal tumor before laparotomy. Intraoperative cholangiography showed stenosis of the intrahepatic bile duct in the anterior inferior segment (B5) and narrowness of the intrahepatic bile duct in the anterior superior segment (B8), so they strongly suspected intrahepatic cholangiocarcinoma (ICC). Histologically, surgically resected liver specimens, which are determined to be without tumor mass by macroscopic observation, showed intraductal papillary proliferation with fibrovascular cores and intraductal spreading of carcinoma in situ throughout a considerable area, especially in bile ductules around the peripheral small portal area. Furthermore, the immunohistochemical profile of the tumor (MUC5AC+/CK7+) was compatible with an intraductal papillary neoplasm of the bile duct (IPN-B). Consequently, this case was diagnosed as IPN-B with spreading CIS, stage I (pT1, pN0, P0, H1, M0). They reported a case of IPN-B with interesting histopathological findings and emphasized that cholangiography is especially helpful for the diagnosis of bile duct dilatation due to the infiltration of carcinoma cells.

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Article adapted by Medical News Today from original press release.
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Reference: Hayashi J, Matsuoka S, Inami', Ohshiro S, Ishigami A, Fujikawa H, Miyagawa M, Mimatsu K, Kuboi Y, Kanou H, Oida T, Moriyama M.
A case of asymptomatic intraductal papillary neoplasm of the bile duct without hepatolithiasis.
World J Gastroenterol 2008; 14(10): 1625-1629 http://www.wjgnet.com/1007-9327/14/1625.asp

Correspondence to: Junpei Hayashi, Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamimachi, Itabashi-ku Tokyo 173-8610, Japan.

About World Journal of Gastroenterology

World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection for providing a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. The WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.

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The WJG Press mainly publishes World Journal of Gastroenterology.

Source: Jing Zhu
World Journal of Gastroenterology