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

Author: Deepali Jain, M.D. (see Authors page)

Revised: 16 November 2017, last major update February 2012

Copyright: (c) 2002-2017,, Inc.

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

Cite this page: Jain, D. Intraductal papillary neoplasms of biliary tract. website. Accessed October 15th, 2018.
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