, 30:459
Date: 19 Jan 2013

Non-invasive intraductal tubular adenoma, pyloric gland type, with malignant foci in the common bile duct

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Intraductal tubular neoplasm (ITN) of the pancreas is very rare; only several cases have been reported in the literature [1, 2]. However, ITN of the hepatobiliary system has not been reported. Herein reported is the first case of ITN, pyloric gland type, with malignant foci in the common bile duct (CBD). An 82-year-old man consulted our hospital because of obstructive jaundice. ERCP showed a mass in the lower CBD. A biopsy during ERCT revealed atypical tubules. Pancreaticoduodenectomy was performed. Grossly, a polypoid tumor (1 × 1 × 1 cm) was recognized in the lower CBD (Fig. 1a, b). Microscopically, the tumor consisted of tubular structures (adenoma of pyloric gland type) resembling pyloric glands (Figs. 1b, 2a). Foci of malignant transformation were seen in the periphery (Fig. 2b). The tumor was non-invasive. Histochemically, the tumor cells contained neutral and acidic mucins. Immunohistochemically, the tumor cells were positive for pancytokeratins (AE1/3 and CAM5.2), cytokeratin ( ...