Intraductal Papillary Neoplasm of the Bile Duct (IPNB): CT and MRI Appearance With Radiology-Pathology Correlation
Clin Imaging . 2020 May 3;66:10-17. doi: 10.1016/j.clinimag.2020.04.036. Online ahead of print.
Anum Aslam, Ashish P Wasnik, Jiaqi Shi, Vaibhav Sahai, Mishal Mendiratta-Lala
Purpose: Intraductal papillary neoplasm of the bile duct (IPNB) is a precursor to invasive carcinoma and is a distinct pathologic diagnosis. The purpose of this study was to evaluate imaging features of IPNB on cross-sectional imaging studies with histopathologic correlation.
Materials and methods: In this IRB approved, HIPAA compliant retrospective observational analysis of 23 pathology proven IPNB tumors 22 imaging studies were reviewed, 14 CT and 8 MRI scans. Features evaluated in consensus by two subspecialty-trained abdominal radiologists included: presence of specific lesion/mass within the bile duct, location within the biliary tree, size, morphology, enhancement characteristics, and bile duct caliber.
Results: Majority of the subjects (16/18, 90%) had definite intraluminal mass, of which 7 (39%) had a polypoid mass with upstream diffuse biliary ductal dilation and 5 (28%) had a plaque-like mass with focal stricture and upstream biliary ductal dilatation. 6/18 (33%) subjects had low grade dysplasia, most commonly intestinal subtype, 7/18 (39%) subjects presented with invasive component, commonly pancreaticobiliary subtype, and 5/18 (28%) presented with high grade dysplasia.
Conclusion: IPNB has increased predilection for extrahepatic bile ducts, commonly presenting as either an intraluminal polypoidal mass with associated upstream biliary ductal dilation or a focal plaque like mass with associated ductal stricture at the site of the tumor.
Read Full Article Here: https://doi.org/10.1016/j.clinimag.2020.04.036