Extrahepatic bile ducts - Biliary intraepithelial neoplasia

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Extrahepatic bile ducts

Tumors

Biliary intraepithelial neoplasia

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 15 February 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Premalignant condition divided into three subtypes (Mod Pathol 2007;20:701):

BilIN-1:
● Flat or micropapillary, basal nuclei, pseudostratification (within lower two thirds of epithelium)
● Mild nuclear abnormalities

BilIN-2:
● Flat, pseudopapillary or micropapillary architecture
● Loss of cellular polarity
● Pseudostratification (reaching the luminal surface), dysplastic nuclear changes
● Peribiliary glands are sometimes involved
● Mitoses are rare

BilIN-3:
● Pseudopapillary or micropapillary architecture
● Cytologically resembles carcinoma but no invasion
● 'Budding off' of small clusters of epithelial cells
● Severe nuclear membrane irregularities

Modified diagnostic criteria for reactive change of the biliary epithelium and biliary intraepithelial neoplasia

Micro images
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Various images

Differential diagnosis
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● Hyperplasia or regenerative change: flat or low papillae, nuclear membrane smooth with fine chromatin, intraepithelial neutrophil infiltration can be seen; variable mitotic figures

End of Extrahepatic bile ducts > Tumors > Biliary intraepithelial neoplasia

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