Takanami Kentaro, Yamada Takayuki, Tsuda Masashi, Takase Kei, Ishida Kazuyuki, Nakamura Yasuhiro, Kanno Atsushi, Shimosegawa Tooru, Unno Michiaki, Takahashi Shoki
Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Seiryomachi, Aoba-ku, Sendai, Japan.
Abdom Imaging. 2011 Aug;36(4):447-56. doi: 10.1007/s00261-010-9649-x.
Mucin-producing intraductal papillary neoplasm (adenocarcinoma/adenoma) in the bile duct is becoming recognized as a specific type of neoplasm. Since, it bears a striking similarity to intraductal papillary mucinous neoplasms of the pancreas with regard to its histopathologic features, the term "intraductal papillary mucinous neoplasms of the bile duct" (IPMN-B) is frequently used, although no definite terminology or definition has been decided by World Health Organization. This neoplasm lacks ovarian-like stroma and communicates with the bile ducts, unlike biliary mucinous cystic neoplasm (MCN). On the other hand, malignant IPMN-B is categorized as an intraductal-growth type of intrahepatic cholangiocarcinoma (ICC). In comparison to other types of ICC, such as the mass-forming type and periductal-infiltrating type that have poor resectability and an unfavorable prognosis, malignant IPMN-B can be resected and demonstrates a more favorable prognosis. Meanwhile, unlike biliary MCN that is usually confined in a closed cyst, IPMN-B can spread along the mucosal surface of the bile ducts, and it should be widely resected. Therefore, multimodality assessment is needed to ensure the correct diagnosis of IPMN-B. We herein review the imaging findings of IPMN-B with pathologic correlation.
胆管内产生黏液的导管内乳头状肿瘤（腺癌/腺瘤）正逐渐被视为一种特定类型的肿瘤。由于其组织病理学特征与胰腺导管内乳头状黏液性肿瘤极为相似，因此常使用“胆管导管内乳头状黏液性肿瘤”（IPMN-B）这一术语，尽管世界卫生组织尚未确定明确的术语或定义。与胆管黏液性囊性肿瘤（MCN）不同，该肿瘤缺乏卵巢样间质且与胆管相通。另一方面，恶性IPMN-B被归类为肝内胆管癌（ICC）的导管内生长型。与其他类型的ICC相比，如具有切除困难和预后不良的肿块形成型和导管周围浸润型，恶性IPMN-B可以切除且预后更佳。同时，与通常局限于封闭囊肿内的胆管MCN不同，IPMN-B可沿胆管黏膜表面扩散，因此应广泛切除。因此，需要多模态评估以确保对IPMN-B的正确诊断。我们在此回顾IPMN-B的影像学表现并与病理结果相关联。
