Biliary papillary tumors share pathological features with... : Hepatology (original) (raw)

Liver Failure and Liver Disease: Liver Disease

Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas

Zen, Yoh1,2; Fujii, Takahiko1; Itatsu, Keita1; Nakamura, Koichi1; Minato, Hiroshi2; Kasashima, Satomi2; Kurumaya, Hiroshi3; Katayanagi, Kazuyoshi3; Kawashima, Atsuhiro4; Masuda, Shinji5; Niwa, Hideki5; Mitsui, Takeshi6; Asada, Yasuyuki6; Miura, Shouji6; Ohta, Tetsuo7; Nakanuma, Yasuni1,*

1_Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa_

2_Division of Pathology, Kanazawa University Hospital, Kanazawa_

3_Department of Pathology, Ishikawa Prefectural Central Hospital, Kanazawa_

4_Department of Pathology, Kanazawa Medical Center, Kanazawa_

5_Department of Pathology, Kouseiren Takaoka Hospital, Takaoka_

6_Department of Surgery, Fukui Saiseikai Hospital, Fukui_

7_Department of Gastroenterologic Surgery, Kanazawa University Graduate School of Medicine, Kanazawa, Japan_

*Department of Human Pathology, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa 920-8640, Japan

Email:[email protected]

Received 26 March 2006; Accepted 19 August 2006

Published online in Wiley InterScience (www.interscience.wiley.com).

Potential conflict of interest: Nothing to report.

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Abstract

Recently, attention has been drawn to papillary neoplasm of the pancreatobiliary systems. In the pancreas, the disease entity of intraductal papillary mucinous neoplasm (IPMN-P) is widely recognized. In contrast, the pathological characteristics of biliary papillary tumors, such as biliary papilloma(tosis) and papillary cholangiocarcinoma, have not yet been well documented. In this study, we compared the pathological features and post-operative prognosis among biliary papillary tumors (10 cases of biliary papilloma(tosis) and 22 cases of papillary cholangiocarcinoma), conventional non-papillary cholangiocarcinoma (15 cases), and IPMN-P (31 cases). Macroscopically, all biliary papillary tumors were characterized by the prominent intraductal papillary proliferation, and macroscopic mucin-hypersecretion was seen in 9 of 32 cases (28%). Histologically, biliary papillary tumors consisted of three types of tumor cells (pancreaticobiliary, intestinal and gastric types), whereas only the pancreaticobiliary type was observed in non-papillary cholangiocarcinoma. Immunohistochemically, biliary papillary tumors were characterized by the common expression of MUC2, CDX2 and cytokeratin 20. In addition, biliary papillary tumors could be associated with two types of invasive lesions: tubular adenocarcinoma (9 cases) and mucinous carcinoma (5 cases). Patients with tubular adenocarcinoma had a poor prognosis compared to non-invasive papillary tumor or papillary tumor with mucinous carcinoma. These pathological characteristics and the survival status of biliary papillary tumors were different from those of non-papillary cholangiocarcinoma, and rather closely resembled those of IPMN-P. In conclusion , biliary papillary tumors may be the biliary counterpart (intraductal papillary neoplasm of the bile duct) of IPMN-P. Supplementary material for this article can be found on the HEPATOLOGY website (http://interscience.wiley.com/jpages/0270-9139/suppmat/index.html).

Copyright © 2006 American Association for the Study of Liver Diseases.