Anum Aslam1, Ashish P Wasnik2, Jiaqi Shi3, Vaibhav Sahai4, Mishal Mendiratta-Lala5. 1. PGY 7, University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-5030, United States of America. Electronic address: aanum@med.umich.edu. 2. Abdominal Radiology, Michigan Medicine, United States of America. Electronic address: ashishw@med.umich.edu. 3. Department of Pathology, Michigan Medicine, United States of America. Electronic address: Jiaqis@med.umich.edu. 4. Department of Internal Medicine, Division of Hematology/Oncology, United States of America. Electronic address: vsahai@med.umich.edu. 5. Abdominal and Cross-Sectional Interventional Radiology, Michigan Medicine, United States of America. Electronic address: mmendira@med.umich.edu.
Abstract
PURPOSE: Intraductal papillary neoplasm of the bile duct (IPNB) is a precursor to invasive carcinoma and is a distinct pathologic diagnosis. The purpose of this study was to evaluate imaging features of IPNB on cross-sectional imaging studies with histopathologic correlation. MATERIALS AND METHODS: In this IRB approved, HIPAA compliant retrospective observational analysis of 23 pathology proven IPNB tumors 22 imaging studies were reviewed, 14 CT and 8 MRI scans. Features evaluated in consensus by two subspecialty-trained abdominal radiologists included: presence of specific lesion/mass within the bile duct, location within the biliary tree, size, morphology, enhancement characteristics, and bile duct caliber. RESULTS: Majority of the subjects (16/18, 90%) had definite intraluminal mass, of which 7 (39%) had a polypoid mass with upstream diffuse biliary ductal dilation and 5 (28%) had a plaque-like mass with focal stricture and upstream biliary ductal dilatation. 6/18 (33%) subjects had low grade dysplasia, most commonly intestinal subtype, 7/18 (39%) subjects presented with invasive component, commonly pancreaticobiliary subtype, and 5/18 (28%) presented with high grade dysplasia. CONCLUSION: IPNB has increased predilection for extrahepatic bile ducts, commonly presenting as either an intraluminal polypoidal mass with associated upstream biliary ductal dilation or a focal plaque like mass with associated ductal stricture at the site of the tumor.
PURPOSE: Intraductal papillary neoplasm of the bile duct (IPNB) is a precursor to invasive carcinoma and is a distinct pathologic diagnosis. The purpose of this study was to evaluate imaging features of IPNB on cross-sectional imaging studies with histopathologic correlation. MATERIALS AND METHODS: In this IRB approved, HIPAA compliant retrospective observational analysis of 23 pathology proven IPNB tumors 22 imaging studies were reviewed, 14 CT and 8 MRI scans. Features evaluated in consensus by two subspecialty-trained abdominal radiologists included: presence of specific lesion/mass within the bile duct, location within the biliary tree, size, morphology, enhancement characteristics, and bile duct caliber. RESULTS: Majority of the subjects (16/18, 90%) had definite intraluminal mass, of which 7 (39%) had a polypoid mass with upstream diffuse biliary ductal dilation and 5 (28%) had a plaque-like mass with focal stricture and upstream biliary ductal dilatation. 6/18 (33%) subjects had low grade dysplasia, most commonly intestinal subtype, 7/18 (39%) subjects presented with invasive component, commonly pancreaticobiliary subtype, and 5/18 (28%) presented with high grade dysplasia. CONCLUSION:IPNB has increased predilection for extrahepatic bile ducts, commonly presenting as either an intraluminal polypoidal mass with associated upstream biliary ductal dilation or a focal plaque like mass with associated ductal stricture at the site of the tumor.
Authors: Matthew H Lee; Venkata S Katabathina; Meghan G Lubner; Hardik U Shah; Srinivasa R Prasad; Kristina A Matkowskyj; Perry J Pickhardt Journal: Radiographics Date: 2021-10 Impact factor: 6.312