Tajima Shogo, Ohata Akihiko, Koda Kenji, Maruyama Yasuhiko
Department of Pathology, Graduate School of Medicine, The University of Tokyo Tokyo, Japan ; Department of Pathology, Fujieda Municipal General Hospital Shizuoka, Japan.
Department of Gastroenterology, Fujieda Municipal General Hospital Shizuoka, Japan.
Int J Clin Exp Pathol. 2015 May 1;8(5):5848-55. eCollection 2015.
Intraductal papillary neoplasm of the bile duct (IPNB) exists in a pathway of multistep-carcinogenesis toward cholangiocarcinoma. Four subtypes are observed in IPNB, pancreatobiliary type, intestinal type, gastric type, and oncocytic type, similarly to the corresponding disease in the pancreas, intraductal papillary mucinous neoplasm (IPMN). IPNB can present with or without macroscopically visible mucin secretion. IPNB usually progresses to tubular adenocarcinoma. However, there are a limited number of well-described cases of gastric-type IPNB progressing not to tubular adenocarcinoma but to colloid carcinoma. Herein, we present a case of an 82-year-old female patient with gastric-type IPNB in the intrapancreatic common bile duct without macroscopically visible mucin secretion, which progressed to colloid carcinoma. As IPNB, especially without visible mucin secretion, is considered to be a heterogeneous group of diseases, such an unexpected association could occur.
胆管内乳头状肿瘤(IPNB)存在于向胆管癌发展的多步骤致癌途径中。在IPNB中观察到四种亚型,即胰胆管型、肠型、胃型和嗜酸细胞型,类似于胰腺中的相应疾病——导管内乳头状黏液性肿瘤(IPMN)。IPNB可伴有或不伴有肉眼可见的黏液分泌。IPNB通常进展为管状腺癌。然而,进展为黏液癌而非管状腺癌的胃型IPNB病例描述有限。在此,我们报告一例82岁女性患者,其胰腺内胆总管存在无肉眼可见黏液分泌的胃型IPNB,该病例进展为黏液癌。由于IPNB,尤其是无可见黏液分泌的IPNB,被认为是一组异质性疾病,因此可能会出现这种意外的关联。