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Morphology of intraductal papillary neoplasm of the bile ducts: radiologic–pathologic correlation

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Abstract

Purpose: Intraductal papillary neoplasm of the bile duct (IPN-B) is known as a premalignant lesion of invasive cholangiocarcinoma. The purpose of this study was for radiologic–pathologic correlation of morphologic features of IPN-B and to correlate the subclassifications with biological behavior in regard to the bile duct wall invasion. Materials and Methods: A pathologist classified gross morphology of 75 cases (44 men and 31 women, age range, 39–85) of histopathologically proven IPN-B into polypoid, cast-like, superficial-spreading, and cyst-forming type. Preoperative images were retrospectively reviewed by two observers independently and classified the gross appearance of intraductal tumors into the four types. Results: The pathologist classified macroscopic appearances of 75 cases of IPN-B into polypoid type in 26, cast-like intraductal growth in 17, superficial-spreading growth in 21, and cyst-forming type in 11. Two observers classified image findings in accordance with pathologist’s classification in 58 and 57 (77% and 76%) among the 75 cases of IPN-B, respectively; 18 and 19 of 26 cases of polypoid type, 14 and 14 of 17 cases of cast-like growth type, 16 and 19 of 21 cases of superficial-spreading type, 10 and 5 of 11 cases of cyst-forming type, respectively. Interobserver agreement for subclassification of tumor morphology was in the category of good agreement (k = 0.651). There was no correlation between morphological subclassification and tendency to invasive cholangiocarcinoma. Conclusion: IPN-Bs can be classified morphologically into polypoid, cast-like growth, superficial-spreading, and cystic type, but there is no correlation between the types and tendency to invasive cholangiocarcinoma.

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Abbreviations

IPN-B:

Intraductal papillary neoplasm of the bile duct

BilIN:

Biliary intraepithelial neoplasia

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Authors and Affiliations

  1. Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul, 135-710, Korea

    Heejung Kim, Jae Hoon Lim, Ji Young Lee, Dongil Choi & Hyo Keun Lim

  2. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Kee Taek Jang

  3. Department of Radiology, Anam Hospital, Korea University School of Medicine, Seoul, Korea

    Min Ju Kim

  4. Department of Radiology, Guro Hospital, Korea University School of Medicine, Seoul, Korea

    Jongmee Lee

  5. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Dong Wook Choi

  6. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jong Kyun Lee

  7. Department of Radiology, University of Chicago School of Medicine, Chicago, IL, USA

    Richard Baron

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  1. Heejung Kim
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  2. Jae Hoon Lim
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Correspondence to Jae Hoon Lim.

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Kim, H., Lim, J.H., Jang, K.T. et al. Morphology of intraductal papillary neoplasm of the bile ducts: radiologic–pathologic correlation. Abdom Imaging 36, 438–446 (2011). https://doi.org/10.1007/s00261-010-9636-2

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  • DOI: https://doi.org/10.1007/s00261-010-9636-2

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