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WHO Classification of Tumours
Intraductal papillary neoplasm (IPN) with an associated invasive carcinoma
Liver and intrahepatic bile ducts


Definition

Intraductal papillary neoplasm (IPN) of the bile ducts is classifiable as low, intermediate or high grade on the basis of degree of cellular and nuclear atypia
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Nakanishi Y, Zen Y, Kondo S, Itoh T, Itatsu K, Nakanuma Y (2008)
Expression of cell cycle-related molecules in biliary premalignant lesions: biliary intraepithelial neoplasia and biliary intraductal papillary neoplasm.
Hum Pathol 39: 1153-61




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Zen Y, Fujii T, Itatsu K, Nakamura K, Konishi F, Masuda S, Mitsui T, Asada Y, Miura S, Miyayama S, Uehara T, Katsuyama T, Ohta T, Minato H, Nakanuma Y (2006)
Biliary cystic tumors with bile duct communication: a cystic variant of intraductal papillary neoplasm of the bile duct.
Mod Pathol 19: 1243-54




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Zen Y, Fujii T, Itatsu K, Nakamura K, Minato H, Kasashima S, Kurumaya H, Katayanagi K, Kawashima A, Masuda S, Niwa H, Mitsui T, Asada Y, Miura S, Ohta T, Nakanuma Y (2006)
Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas.
Hepatology 44: 1333-43



. IPNs are not infrequently associated with invasive carcinoma. IPN with an associated invasive ICC in the intrahepatic bile ducts corresponds to the IG (intraductal-growth) type of ICC. When an invasive carcinoma is present, it should be separately designated and staged.

Although IPN of the bile ducts is usually not so mucinous, there are a number of parallels between IPN of the bile ducts and intraductal papillary mucinous neoplasm (IPMN) of the pancreas

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Klöppel G, Kosmahl M (2006)
Is the intraductal papillary mucinous neoplasia of the biliary tract a counterpart of pancreatic papillary mucinous neoplasm?
J Hepatol 44: 249-50




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Shibahara H, Tamada S, Goto M, Oda K, Nagino M, Nagasaka T, Batra SK, Hollingsworth MA, Imai K, Nimura Y, Yonezawa S (2004)
Pathologic features of mucin-producing bile duct tumors: two histopathologic categories as counterparts of pancreatic intraductal papillary-mucinous neoplasms.
Am J Surg Pathol 28: 327-38




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Zen Y, Fujii T, Itatsu K, Nakamura K, Konishi F, Masuda S, Mitsui T, Asada Y, Miura S, Miyayama S, Uehara T, Katsuyama T, Ohta T, Minato H, Nakanuma Y (2006)
Biliary cystic tumors with bile duct communication: a cystic variant of intraductal papillary neoplasm of the bile duct.
Mod Pathol 19: 1243-54




Click to access Pubmed
Zen Y, Fujii T, Itatsu K, Nakamura K, Minato H, Kasashima S, Kurumaya H, Katayanagi K, Kawashima A, Masuda S, Niwa H, Mitsui T, Asada Y, Miura S, Ohta T, Nakanuma Y (2006)
Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas.
Hepatology 44: 1333-43



. Both lesions are papillary and intraductal, both show similar range of possible differentiation of the neoplastic cells (pancreatobiliary type, intestinal type, oncocytic type, and gastric type), and both have similar types of associated invasive carcinomas
Click to access Pubmed
Zen Y, Fujii T, Itatsu K, Nakamura K, Minato H, Kasashima S, Kurumaya H, Katayanagi K, Kawashima A, Masuda S, Niwa H, Mitsui T, Asada Y, Miura S, Ohta T, Nakanuma Y (2006)
Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas.
Hepatology 44: 1333-43



. The pancreatobiliary type is the most common type of IPN of the bile ducts. As in the pancreas, when associated with an invasive carcinoma, the pancreatobiliary type of bile-duct IPN is usually associated with a tubular adenocarcinoma, while the intestinal type of bile-duct IPN is usually associated with a colloid type of invasive carcinoma
Click to access Pubmed
Klöppel G, Kosmahl M (2006)
Is the intraductal papillary mucinous neoplasia of the biliary tract a counterpart of pancreatic papillary mucinous neoplasm?
J Hepatol 44: 249-50




Click to access Pubmed
Shibahara H, Tamada S, Goto M, Oda K, Nagino M, Nagasaka T, Batra SK, Hollingsworth MA, Imai K, Nimura Y, Yonezawa S (2004)
Pathologic features of mucin-producing bile duct tumors: two histopathologic categories as counterparts of pancreatic intraductal papillary-mucinous neoplasms.
Am J Surg Pathol 28: 327-38




Click for details
Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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