Intraductal papillary neoplasia of the liver associated with hepatolithiasis

Citation
Tc. Chen et al., Intraductal papillary neoplasia of the liver associated with hepatolithiasis, HEPATOLOGY, 34(4), 2001, pp. 651-658
Citations number
30
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenerology and Hepatology","da verificare
Journal title
HEPATOLOGY
ISSN journal
0270-9139 → ACNP
Volume
34
Issue
4
Year of publication
2001
Part
1
Pages
651 - 658
Database
ISI
SICI code
0270-9139(200110)34:4<651:IPNOTL>2.0.ZU;2-E
Abstract
Intraductal papillary growth of neoplastic biliary epithelia with a fine fi brovascular stalk (intraductal papillary neoplasia of liver [IPN-L]) resemb ling intraductal papillary mucinous neoplasm of pancreas is occasionally as sociated with hepatolithiasis. In this study, 136 cases of hepatolithiasis in Taiwan, between January 1998 and March 2000, and an additional 21 cases of IPN-L before December 1998, were examined histologically. IPN-L was foun d in 41 of 136 hepatolithiasis cases (30.1%). Sixty-two IPN-L cases (42 wom en and 20 men; age range, 59.8 +/- 10 years) were divided into 4 types (typ e 1, IPN-L with low-grade dysplasia, 23 cases; type 2, IPN-L with high grad e dysplasia, 11 cases; type 3, IPN-L with in situ and microinvasive carcino ma, 13 cases; and type 4, IPN-L of types 2 and 3 with distinct invasive car cinoma, 15 cases). Intraductal spreading and glandular involvement were com monly observed in all types. About half of types 3 and 4 cases had mucobili a, and mucinous carcinoma was variably found in two thirds of group 4 patie nts. IPN-L frequently showed variable gastroenteric differentiation such as goblet cells and foveolar and colon-like metaplasia. IPN-L with goblet cel ls and colon-like metaplasia was frequently associated with overproduction of mucin and mucobilia (P < .01). In Japan, IPN-L was not frequent in hepat olithiasis (12 of 135 cases). In conclusion, IPN-L forms a spectrum of bili ary neoplasm in hepatolithiasis. It often displays variable gastroenteric m etaplasia and significant intraductal spread. IPN-L tends to progress to mu cinous carcinoma. Formerly reported "mucin-producing intrahepatic cholan-gi ocarcinoma" with a favorable prognosis is included in IPN-L.