Intraductal papillary neoplasm of the bile duct with metachronous development in the downstream bile duct after radical resection.
Bile duct segmental resection
Intrabiliary dissemination
Intraductal papillary neoplasm of the bile duct
Metachronous development
Papillary cholangiocarcinoma
Journal
Clinical journal of gastroenterology
ISSN: 1865-7265
Titre abrégé: Clin J Gastroenterol
Pays: Japan
ID NLM: 101477246
Informations de publication
Date de publication:
14 Oct 2023
14 Oct 2023
Historique:
received:
04
03
2023
accepted:
17
09
2023
medline:
15
10
2023
pubmed:
15
10
2023
entrez:
14
10
2023
Statut:
aheadofprint
Résumé
We report a case of intraductal papillary neoplasms of the bile duct (IPNB) that metachronously developed twice in the downstream bile duct after radical resection. The first lesion was located in the left intrahepatic bile duct, the second lesion in the perihilar bile duct, and the third lesion in the distal bile duct. All lesions were IPNBs with associated invasive carcinoma (pancreatobiliary type). The depth of invasion was to the Glisson's capsule in the first lesion, to the subserosa in the second lesion, and to the fibromuscular layer in the third lesion, without lympho-vascular/perineural invasion and lymph-node metastasis. These were resected radically and had no biliary intraepithelial neoplasia and hyperplasia in the surrounding mucosa. In immunohistochemical examination, each lesion showed a different pattern. Although the downstream occurrence suggests intrabiliary dissemination, the mechanism of these metachronous developments may be multicentric. A literature review revealed that most metachronous cholangiocarcinomas have a grossly papillary appearance and tend to arise downstream. Our findings suggest that IPNB may develop metachronously in the residual bile duct after radical surgery, which may assist in early detection.
Identifiants
pubmed: 37837506
doi: 10.1007/s12328-023-01867-x
pii: 10.1007/s12328-023-01867-x
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. Japanese Society of Gastroenterology.
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