Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
Pathol Int. 2010 Jun;60(6):419-29. doi: 10.1111/j.1440-1827.2010.02543.x.
There are peribiliary glands around the biliary tract, and these glands drain into the bile duct lumen. Interestingly, small amounts of pancreatic exocrine acini are intermingled with these glands. Experimental studies using animals suggest that the biliary tract shows some potential for pancreatic differentiation. It is noteworth that the biliary tract and pancreas have similar pathological features. IgG4-related sclerosing cholangitis and autoimmune pancreatitis are representative inflammatory diseases with similar features. Intraductal papillary neoplasms are found in the biliary tract and also in the pancreas: intraductal papillary neoplasm of the bile duct (IPNB) and intraductal papillary mucinous neoplasm of the pancreas (IPMN). IPNB and IPMN share common histologic and phenotypic features and biological behaviors. Interestingly, mucinous cystic neoplasm (MCN) arises in both the pancreas and the hepatobiliary system. Intraductal tubular neoplasia is found in both the biliary tract and pancreas as well. Intraepithelial neoplasm is found in the biliary tract and pancreas: biliary intraepithelial neoplasm (BilIN) and pancreatic intraepithelial neoplasm (PanIN). BilIN and PanIN are followed by conventional invasive adenocarcinoma, while IPNB and IPMN are followed by tubular adenocarcinoma and mucinous carcinoma in both organs. Further study of the biliary tract's pathophysiology based on its similarity to pancreatic counterparts is warranted.
胆道周围有胆管旁腺体，这些腺体排入胆管腔。有趣的是，少量胰腺外分泌腺泡与这些腺体混合在一起。动物实验研究表明，胆管具有一定的胰腺分化潜能。值得注意的是，胆管和胰腺具有相似的病理特征。IgG4 相关硬化性胆管炎和自身免疫性胰腺炎是具有相似特征的代表性炎症性疾病。胆管和胰腺都可发生导管内乳头状肿瘤：胆管内乳头状瘤（IPNB）和胰腺导管内乳头状黏液性肿瘤（IPMN）。IPNB 和 IPMN 具有共同的组织学和表型特征以及生物学行为。有趣的是，黏液性囊腺瘤（MCN）既可发生于胰腺，也可发生于肝胆系统。胆管和肝胆系统均可发生导管内管状肿瘤。上皮内肿瘤也可发生于胆管和胰腺：胆管上皮内瘤（BilIN）和胰腺上皮内瘤（PanIN）。BilIN 和 PanIN 之后是常规浸润性腺癌，而 IPNB 和 IPMN 之后分别是管状腺癌和黏液性腺癌。有必要基于与胰腺对应物的相似性进一步研究胆管的病理生理学。
