Biliary Intraductal Papillary-Mucinous Neoplasm Manifesting Only as Dilatation of the Hepatic Lobar or Segmental Bile Ducts: Imaging Features in Six Patients
Jae Hoon Lim1,
Kee-Taek Jang2 and
Dongil Choi1
1 Department of Radiology and Center for Imaging Science, Samsung Medical
Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku,
Seoul, Korea.
2 Department of Pathology, Samsung Medical Center, Sungkyunkwan University
School of Medicine, Seoul, Korea.
View larger version (143K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1A —73-year-old man with intraductal papillary-mucinous adenoma
spreading along entire length of intrahepatic bile ducts of left hepatic lobe.
Unenhanced CT images show severe dilatation of bile ducts of left hepatic lobe
containing several small calcified stones (arrows).
|
|
View larger version (160K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1B —73-year-old man with intraductal papillary-mucinous adenoma
spreading along entire length of intrahepatic bile ducts of left hepatic lobe.
Unenhanced CT images show severe dilatation of bile ducts of left hepatic lobe
containing several small calcified stones (arrows).
|
|
View larger version (148K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1C —73-year-old man with intraductal papillary-mucinous adenoma
spreading along entire length of intrahepatic bile ducts of left hepatic lobe.
Contrast-enhanced CT images show severe dilatation of bile ducts of left
hepatic lobe with no visible hepatic parenchyma because of severe parenchymal
atrophy. Dilated intrahepatic ducts are filled with fluid and small stones
(arrows).
|
|
View larger version (168K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1D —73-year-old man with intraductal papillary-mucinous adenoma
spreading along entire length of intrahepatic bile ducts of left hepatic lobe.
Contrast-enhanced CT images show severe dilatation of bile ducts of left
hepatic lobe with no visible hepatic parenchyma because of severe parenchymal
atrophy. Dilated intrahepatic ducts are filled with fluid and small stones
(arrows).
|
|
View larger version (153K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1E —73-year-old man with intraductal papillary-mucinous adenoma
spreading along entire length of intrahepatic bile ducts of left hepatic lobe.
Endoscopic retrograde cholangiogram shows marked dilatation of intrahepatic
and extrahepatic ducts. Large and small filling defects (arrows) due
to stones and mucin are evident.
|
|
View larger version (72K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1F —73-year-old man with intraductal papillary-mucinous adenoma
spreading along entire length of intrahepatic bile ducts of left hepatic lobe.
Photograph of resected specimen of left hepatic lobe shows severe dilatation
of bile ducts with fibrous thickening (arrows). Hepatic parenchyma is
almost absent. No tumor is visible in dilated bile ducts. Bile ducts were
filled with mucopurulent fluid.
|
|
View larger version (113K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 1G —73-year-old man with intraductal papillary-mucinous adenoma
spreading along entire length of intrahepatic bile ducts of left hepatic lobe.
Photomicrograph shows intraductal proliferation of papillary-mucinous
epithelium of adenoma. (H and E, x40)
|
|
View larger version (164K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2A —66-year-old woman with epithelial hyperplasia and moderate to
severe dysplasia of entirety of right hepatic bile ducts. Contrast-enhanced CT
images show markedly dilated bile ducts in right and left hepatic lobes and
extrahepatic ducts (arrow, C). Severe parenchymal atrophy of
right hepatic lobe is evident. GB = gallbladder.
|
|
View larger version (167K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2B —66-year-old woman with epithelial hyperplasia and moderate to
severe dysplasia of entirety of right hepatic bile ducts. Contrast-enhanced CT
images show markedly dilated bile ducts in right and left hepatic lobes and
extrahepatic ducts (arrow, C). Severe parenchymal atrophy of
right hepatic lobe is evident. GB = gallbladder.
|
|
View larger version (164K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2C —66-year-old woman with epithelial hyperplasia and moderate to
severe dysplasia of entirety of right hepatic bile ducts. Contrast-enhanced CT
images show markedly dilated bile ducts in right and left hepatic lobes and
extrahepatic ducts (arrow, C). Severe parenchymal atrophy of
right hepatic lobe is evident. GB = gallbladder.
|
|
View larger version (135K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2D —66-year-old woman with epithelial hyperplasia and moderate to
severe dysplasia of entirety of right hepatic bile ducts. Cholangiogram
through drainage catheter shows severe dilatation of extrahepatic duct
containing multiple elongated filling defects (arrows) caused by
mucin.
|
|
View larger version (130K):
[in this window]
[in a new window]
[as a PowerPoint slide]
|
Fig. 2E —66-year-old woman with epithelial hyperplasia and moderate to
severe dysplasia of entirety of right hepatic bile ducts. Photomicrograph of
pathologic specimen shows intraductal proliferation of papillary-mucinous
epithelium of high-grade dysplasia and dysplastic cells diffusely lining bile
ducts. (H and E, x40)
|
|
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Copyright © 2008 by the American Roentgen Ray Society.
