Liver and intrahepatic bile ducts - tumor
Benign tumors / conditions
Intraductal papillary neoplasms of biliary tract

Topic Completed: 1 February 2012

Revised: 30 May 2019

Copyright: (c) 2002-2019,, Inc.

PubMed Search: Intraductal papillary neoplasms of biliary tract[TIAB]

Deepali Jain, M.D.
Page views in 2018: 1,083
Page views in 2019 to date: 1,027
Cite this page: Jain D. Intraductal papillary neoplasms of biliary tract. website. Accessed September 19th, 2019.
Definition / general
  • Uncommon tumor arising from peribiliary glands (AJR Am J Roentgenol 2011;197:1111)
  • Solitary or may spread along biliary tree to cystic duct or duodenal papilla
  • May resemble intrapapillary mucinous neoplasms of pancreas, as both arise within a dilated duct system and demonstrate predominantly intraductal growth
  • Associated with Clonorchis sinensis infection (Virchows Arch 2008;453:589)
  • Often are carcinomas
  • Risk factor for cholangiocarcinoma, biliary obstruction, recurring ascending cholangitis
Microscopic (histologic) description
  • Papillary fronds with fine vascular cores
  • Epithelial cells are either pancreaticobiliary type, have gastric or intestinal differentiation with goblet cells and Paneth cells or have oncocytic cells (Hum Pathol 2009;40:1543)
  • Production of extracellular intraductal mucin less common than pancreatic IPMNs
  • However, mucin producing IPMN of bile ducts show striking similarities to pancreatic IPMN and nonmucin producing IPM of bile ducts is heterogenous disease (Am J Surg Pathol 2011;35:512)
  • Borderline tumors: mild to moderate nuclear atypia and nuclear pseudostratification limited to basal 2/3 of the epithelium
  • Carcinomas: severe cytological atypia, loss of nuclear polarity or architectural cribriforming / papillary fusion is present
Positive stains
Negative stains
Molecular / cytogenetics description
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