A case of invasive cholangiocarcinoma with diffuse biliary intraepithelial neoplasia

DOI
  • Ohnishi Toshio
    Department of Surgical Oncology, Kanazawa Medical University
  • Ueda Nobuhiko
    Department of Surgical Oncology, Kanazawa Medical University
  • Miura Seiko
    Department of Surgical Oncology, Kanazawa Medical University
  • Kaida Daisuke
    Department of Surgical Oncology, Kanazawa Medical University
  • Fujita Hideto
    Department of Surgical Oncology, Kanazawa Medical University
  • Kinami Shinichi
    Department of Surgical Oncology, Kanazawa Medical University
  • Kosaka Takeo
    Department of Surgical Oncology, Kanazawa Medical University
  • Nakata Satoko
    Department of Pathology and Laboratory Medicine, Kanazawa Medical University

Bibliographic Information

Other Title
  • 広範囲な胆管内上皮内腫瘍を伴った浸潤性胆管癌の1例

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Abstract

<p>A 75-year-old woman was referred to our clinic for evaluation of obstructive jaundice. A CT scan revealed stenosis of the distal bile duct at the near portion of the papilla of Vater, with thickness and enhancement at this site. In addition, gallbladder contained 3 elevated lesions. Cytology of the bile obtained from PTBD was positive for malignancy. Under the diagnosis of the carcinoma at the distal bile duct and gallbladder, surgery was performed. The intraoperative evaluation of the common hepatic duct margin, just below the confluence of the left and right hepatic ducts, demonstrated epithelial dysplasia. Based on this finding, a subtotal stomach-preserving pancreaticoduodenectomy was performed without further excision of the bile duct. The postoperative pathology showed invasive cholangiocarcinoma at the distal bile duct with biliary intraepithelial neoplasia (BilIN) extending from the papilla of Vater to the intrahepatic bile duct of the liver bed and gallbladder. The patient survived for 22 months with chemotherapy. We hypothesized that this particular case of invasive cholangiocarcinoma arose from the pre-existing BilIN in the distal common bile duct.</p>

Journal

  • Tando

    Tando 30 (4), 741-748, 2016

    Japan Biliary Association

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