Malignant Papillary Neoplasms of the Intrahepatic Bile Ducts
CT and Histopathologic Features
Kwon-Ha Yoon1,
Hyun Kwon Ha2,
Chang Ghun Kim1,
Byung Suk Roh1,
Ki Jung Yun3,
Kwon Mook Chae4,
Jae Hoon Lim5 and
Yong Ho Auh2
1
Department of Radiology, Wonkwang University School of Medicine, 344-2
Singyong-dong, Iksan, Chunbuk 570-180, Korea.
2
Department of Radiology, Asan Medical Center, University of Ulsan College of
Medicine, 388-1, Poongnab-dong, Songpa-ku, Seoul 138-040, Korea.
3
Department of Pathology, Wonkwang University School of Medicine, Chunbuk
570-180, Korea.
4
Department of General Surgery, Wonkwang University School of Medicine, Chunbuk
570-180, Korea.
5
Department of Radiology, Samsung Medical Center, Sunggyunkwan University
School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Korea.
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Fig. 1A. —54-year-old man with intraductal papillary adenocarcinoma.
Contrast-enhanced CT scan shows well-defined round hypoattenuated nodule
(arrows) in right intrahepatic ducts. Note dilatation of bile ducts
proximal to tumor.
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Fig. 1B. —54-year-old man with intraductal papillary adenocarcinoma. Gross
specimen shows locally dilated bile duct with polypoid nodule
(arrows) measuring 2.0 x 2.0 cm in right intrahepatic duct.
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Fig. 1C. —54-year-old man with intraductal papillary adenocarcinoma.
Photomicrograph reveals papillary elements of adenocarcinoma (arrows)
impinging on dilated ductal lumen without infiltration into hepatic
parenchyma. (H and E, x100)
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Fig. 2A. —56-year-old man with papillary adenocarcinoma in right intrahepatic
bile duct. Contrast-enhanced CT scan shows mild dilatation of right
anterosuperior segmental duct (arrow) without visible tumor.
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Fig. 2B. —56-year-old man with papillary adenocarcinoma in right intrahepatic
bile duct. Gross specimen shows intraductal sessile nodule (arrows)
in right intrahepatic bile duct.
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Fig. 2C. —56-year-old man with papillary adenocarcinoma in right intrahepatic
bile duct. Photomicrograph shows well-differentiated papillary adenocarcinoma
composed of papillary proliferation of biliary epithelial cells
(arrows) with invasion into fibromuscular layer. (H and E,
x100)
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Fig. 3A. —68-year-old man with adenocarcinoma with papillomatosis at
intrahepatic bile duct. Contrast-enhanced CT scan shows poorly defined,
hypoattenuated lesions along left intrahepatic bile duct (arrows)
with proximal dilatation of bile duct.
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Fig. 3B. —68-year-old man with adenocarcinoma with papillomatosis at
intrahepatic bile duct. Gross specimen shows innumerable granular and polypoid
mucosal lesions (arrows) along left intrahepatic duct to peripheral
interlobular duct without invasion of hepatic parenchyma.
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Fig. 4A. —40-year-old-woman with mucin-hypersecreting papillary adenocarcinoma
of intrahepatic duct. Contrast-enhanced CT scan shows hypoattenuated cystic
mass (solid arrows) with central enhancing polypoid mass
(arrowheads). Note mild dilatation of intrahepatic duct proximal to
cystic mass (open arrow).
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Fig. 4B. —40-year-old-woman with mucin-hypersecreting papillary adenocarcinoma
of intrahepatic duct. Gross specimen shows cystic mass measuring 4.5 x
4.0 cm (arrows) and containing mucinous fluid. Tumor did not form
true cyst but formed focally dilated biliary tree with papillary growth mass
and carcinomatous change.
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