Comparative radiological pathological study of biliary intraductal tubulopapillary neoplasm and biliary intraductal papillary mucinous neoplasm
| Autor: | Yu-Chuan Tsuei, Chia-Hung Wu, Hsiou-Shan Tseng, Chien-An Liu, Chia-I Lin, Yi-You Chiou, Nai-Chi Chiu, Yi-Chen Yeh, Li-Kuo Huang |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Urology Gastroenterology 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Pathological Aged Retrospective Studies Lung Radiological and Ultrasound Technology Intraductal papillary mucinous neoplasm medicine.diagnostic_test Bile duct business.industry Soft tissue Magnetic resonance imaging Hepatology Middle Aged medicine.disease Adenocarcinoma Mucinous Magnetic Resonance Imaging Carcinoma Papillary Survival Rate medicine.anatomical_structure Biliary Tract Neoplasms Biliary tract 030220 oncology & carcinogenesis Female business |
| Zdroj: | Abdominal radiology (New York). 42(10) |
| ISSN: | 2366-0058 |
| Popis: | Biliary tract intraductal tubulopapillary neoplasms (BT-ITPNs) and intraductal papillary mucinous neoplasms (BT-IPMNs) are rare and poorly described. Herein, we examined the magnetic resonance imaging (MRI) features of BT-ITPNs and BT-IPMNs and correlated them with key gross and microscopic pathological findings. We retrospectively identified five patients with definitive pathological findings of BT-ITPN and available diagnostic MRI findings. Key MRI features were correlated to the gross and microscopic pathology and compared to those of BT-IPMNs (19 patients). All BT-ITPNs showed ductal dilatation and visible intraductal soft tissue with peribiliary liver parenchyma enhancement. One BT-ITPN patient had synchronous lung metastases, and another showed rapid tumor growth rate. The intraductal soft tissue proportion of BT-ITPNs was significantly more than that of BT-IPMNs (p < 0.05). CA-199 level was elevated in 60% of BT-ITPN cases. The overall combined 1-year and 3-year survival rates in the BT-ITPN group was 100% and 40%, and in the BT-IPMN group was 100% and 58%, respectively. A high intraductal soft tissue proportion, a lack of intraluminal mucin, and immunohistochemical absence of MUC5AC are radiological and pathological characteristics that differentiate BT-ITPN from BT-IPMN. Although rare, BT-ITPN should be suspected when solid intraductal soft tissue and peribiliary liver parenchyma enhancement are present, particularly if the bile duct upstream and downstream of the lesion have a normal diameter, without mucin. Owing to the aggressive nature of the tumor, recognition of these features may indicate the need for more aggressive treatment in selected patients. |
| Databáze: | OpenAIRE |
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