As a rare biliary tract tumor, intraductal papillary neoplasm of the bile duct (IPNB) is most common in elderly men and can progress to cholangiocarcinoma- (CCa) if left untreated. It is reported that IPNB usually communicates with the bile duct. As a result, the downstream bile ducts are imaged asymmetrically dilated. However, a case of IPNB that we report here is different. Enhanced MRI revealed a lack of connectivity with the bile duct in this case. Based on this, the purpose of this case study is to suggest that the majority of imaging doctors should widely understand the various imaging manifestations of the disease to avoid misdiagnosis. In addition, although this feature was not indicated by ultrasound in this case, given previous studies and considering the convenience and non-ionizing radiation damage of CEUS, we recommend its use as a screening method for IPNB to improve diagnostic accuracy.
BartonJG, BarrettDA, MaricevichMA, SchnelldorferT, WoodCM, SmyrkTC, et al. Intraductal papillary mucinous neoplasm of the biliary tract: A real disease? HPB (Oxford). 2009;11(8):684–91.
2.
LeeSS, KimMH, LeeSK, JangSJ, SongMH, KimKP, et al. Clinicopathologic review of 58 patients with biliary papillomatosis. Cancer. 2004;100(4):783–93.
3.
ParkHJ, KimSY, KimHJ, LeeSS, HongGS, ByunJH, et al. Intraductal papillary neoplasm of the bile duct: Clinical, imaging, and pathologic features. AJR Am J Roentgenol. 2018;211(1):67–75.
4.
EgriC, YapWW, ScudamoreCH, WebberD, HarrisA.Intraductal papillary neoplasm of the bile duct: Multimodality imaging appearances and pathological correlation. Can Assoc Radiol J. 2017;68(1):77–83.
5.
ZhengQ, RuanSM, ShanQY, XuM, ChenLD, HuHT,et al. Clinicopathological findings and imaging features of intraductal papillary neoplasm of the bile duct: Comparison between contrast-enhanced ultrasound and contrast-enhanced computed tomography. Abdom Radiol (NY). 2019;44(7):2409–17.
6.
ChenTC, NakanumaY, ZenY, ChenMF, JanYY, YehTS, et al. Intraductal papillary neoplasia of the liver associated with hepatolithiasis. Hepatology. 2001;34(4 Pt 1):651–8.
7.
ZenY, JangKT, AhnS, KimDH, ChoiDW, ChoiSH,et al. Intraductal papillary neoplasms and mucinous cystic neoplasms of the hepatobiliary system: Demographic differences between Asian and Western populations, and comparison with pancreatic counterparts. Histopathology. 2014;65(2):164–73.
8.
WangX, CaiYQ, ChenYH, LiuXB.Biliary tract intraductal papillary mucinous neoplasm: Report of 19 cases. World J Gastroenterol. 2015;21(14):4261–7.
9.
OhtsukaM, ShimizuH, KatoA, YoshitomiH, FurukawaK, TsuyuguchiT, et al. Intraductal papillary neoplasms of the bile duct. Int J Hepatol. 2014)459091.
10.
KubotaK, NakanumaY, KondoF, HachiyaH, MiyazakiM, NaginoM,et al. Clinicopathological features and prognosis of mucin-producing bile duct tumor and mucinous cystic tumor of the liver: A multi-institutional study by the Japan Biliary Association. J Hepatobiliary Pancreat Sci. 2014;21(3):176–85.
11.
AdsayNV, ConlonKC, ZeeSY, BrennanMF, KlimstraDS.Intraductal papillary-mucinous neoplasms of the pancreas. Cancer. 2002;94(1):62–77.
12.
AinechiS, LeeH.Updates on precancerous lesions of the biliary tract: Biliary precancerous lesion. Arch Pathol Lab Med. 2016;140(11):1285–9.
13.
LüttgesJ, ZamboniG, LongneckerD, KlöppelG.The immunohistochemical mucin expression pattern distinguishes different types of intraductal papillary mucinous neoplasms of the pancreas and determines their relationship to mucinous noncystic carcinoma and ductal adenocarcinoma. The American Journal of Surgical Pathology. 2001;25(7):942–8.
14.
ZenY, FujiiT, ItatsuK, NakamuraK, KonishiF, MasudaS,et al. Biliary cystic tumors with bile duct communication: A cystic variant of intraductal papillary neoplasm of the bile duct. Mod Pathol. 2006;19(9):1243–54.
ZhangQ, QiuYJ, YangDH, LuXY, ChenS, DongY,et al. Differential diagnosis between pancreatic solid pseudopapillary tumors and pancreatic neuroendocrine tumors based on contrast enhanced ultrasound imaging features. Clin Hemorheol Microcirc. 2023;85(4):421–31.
18.
WernerJM, ZidekM, KammererS, daSilva NPB, JungF, SchlittHJ,et al. Intraoperative contrast-enhanced ultrasound can have a crucial role in surgical decision-making during hepato-pancreatico-biliary surgery –Analysis of impact and input. Clin Hemorheol Microcirc. 2021;78(1):103–16.
