Clinicopathological aspects and diagnostic problems in patients with intraductal papillary neoplasm of the bile duct

Abstract

Background/Aim: Intraductal papillary neoplasm of the bile duct (IPNB) is defined as a non-invasive malignancy and disparity of its histological diagnosis with related diseases remains. Patients and Methods: Twenty-six cases of IPNB and 12 of papillary adenocarcinomas (PAC) at two Institutes were investigated. Results: The prevalence of biliary dilatation and mucin secretion in the group with IPNB was significantly higher compared to the group with PAC (p<0.01). IPNB was predominantly located in the proximal bile duct compared to the location of PAC (p<0.01). Mis-matching of a second histological diagnosis was observed in 27% of IPNB and 25% of PAC, respectively. The prevalence of tumor relapse was significantly higher in PAC than in IPNB (p<0.05), and the overall survival was significantly better in IPNB than in PAC (p<0.01). Conclusion: Although IPNB is currently defined under histological criteria, morphologies were various and disparity in histological diagnosis for IPNB remains problematic when the clinical strategy is contemplated.