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Gastrointestinal
Diagnosis
Biliary System
Malignant Neoplasms
Biliary IPMN
Biliary IPMN
Siva P. Raman, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Intraductal papillary mucinous neoplasm (IPMN)

          • Synonyms

            • Intraductal papillary neoplasm of liver, intraductal papillary neoplasm of bile duct (IPNB), mucin-secreting biliary papillomatosis, mucin-producing cholangiocarcinoma, mucinous ductal ectasia of biliary tree

          • Definitions

            • Mucin-producing papillary neoplasm arising from biliary mucosa
              • Only added to WHO classification in 2010
              • Significant overlap with biliary papillomatosis; some authors suggest these are same entity

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Aslam A et al: Intraductal papillary neoplasm of the bile duct (IPNB): CT and MRI appearance with radiology-pathology correlation. Clin Imaging. 66:10-17, 2020
                                              2. Li J et al: Magnetic resonance imaging versus computed tomography for biliary tract intraductal papillary mucinous neoplasm (BT-IPMN): a diagnostic performance analysis. Med Sci Monit. 26:e920952, 2020
                                              3. Raphael KL et al: Digital cholangioscopy in a patient with biliary tract intraductal papillary mucinous neoplasm. VideoGIE. 4(11):517-8, 2019
                                              4. Park HJ et al: Intraductal papillary neoplasm of the bile duct: clinical, imaging, and pathologic features. AJR Am J Roentgenol. 211(1):67-75, 2018
                                              5. Bal MM et al: Intraductal papillary neoplasm of the bile duct: a rarity. Indian J Pathol Microbiol. 57(1):144-5, 2014
                                              6. Ohtsuka M et al: Intraductal papillary neoplasms of the bile duct. Int J Hepatol. 2014:459091, 2014
                                              7. Wan XS et al: Intraductal papillary neoplasm of the bile duct. World J Gastroenterol. 19(46):8595-604, 2013
                                              8. Jung G et al: Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct. J Hepatol. 57(4):787-93, 2012
                                              9. Rocha FG et al: Intraductal papillary neoplasm of the bile duct: A biliary equivalent to intraductal papillary mucinous neoplasm of the pancreas? Hepatology. 56(4):1352-60, 2012
                                              10. Lim JH et al: Cyst-forming intraductal papillary neoplasm of the bile ducts: description of imaging and pathologic aspects. AJR Am J Roentgenol. 197(5):1111-20, 2011
                                              11. Takanami K et al: Intraductal papillary mucininous neoplasm of the bile ducts: multimodality assessment with pathologic correlation. Abdom Imaging. 36(4):447-56, 2011
                                              12. Takanami K et al: FDG PET/CT findings in malignant intraductal papillary mucinous neoplasm of the bile ducts. Clin Nucl Med. 35(2):83-5, 2010
                                              13. Bickenbach K et al: Molecular mechanisms of cholangiocarcinogenesis: are biliary intraepithelial neoplasia and intraductal papillary neoplasms of the bile duct precursors to cholangiocarcinoma? Surg Oncol Clin N Am. 18(2):215-24, vii, 2009
                                              14. Lim JH et al: Biliary intraductal papillary-mucinous neoplasm manifesting only as dilatation of the hepatic lobar or segmental bile ducts: imaging features in six patients. AJR Am J Roentgenol. 191(3):778-82, 2008
                                              15. Lim JH et al: Biliary cystic intraductal papillary mucinous tumor and cystadenoma/cystadenocarcinoma: differentiation by CT. Abdom Imaging. 32(5):644-51, 2007
                                              16. Zen Y et al: Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas. Hepatology. 44(5):1333-43, 2006
                                              17. Lim JH et al: Intraductal papillary mucinous tumor of the bile ducts. Radiographics. 24(1):53-66; discussion 66-7, 2004
                                              18. Sugiyama M et al: Magnetic resonance cholangiopancreatography for postoperative follow-up of intraductal papillary-mucinous tumors of the pancreas. Am J Surg. 185(3):251-5, 2003
                                              19. Oshikiri T et al: Mucin-secreting bile duct adenoma--clinicopathological resemblance to intraductal papillary mucinous tumor of the pancreas. Dig Surg. 19(4):324-7, 2002
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Intraductal papillary mucinous neoplasm (IPMN)

                                                      • Synonyms

                                                        • Intraductal papillary neoplasm of liver, intraductal papillary neoplasm of bile duct (IPNB), mucin-secreting biliary papillomatosis, mucin-producing cholangiocarcinoma, mucinous ductal ectasia of biliary tree

                                                      • Definitions

                                                        • Mucin-producing papillary neoplasm arising from biliary mucosa
                                                          • Only added to WHO classification in 2010
                                                          • Significant overlap with biliary papillomatosis; some authors suggest these are same entity

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Nuclear Medicine Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Aslam A et al: Intraductal papillary neoplasm of the bile duct (IPNB): CT and MRI appearance with radiology-pathology correlation. Clin Imaging. 66:10-17, 2020
                                                                                          2. Li J et al: Magnetic resonance imaging versus computed tomography for biliary tract intraductal papillary mucinous neoplasm (BT-IPMN): a diagnostic performance analysis. Med Sci Monit. 26:e920952, 2020
                                                                                          3. Raphael KL et al: Digital cholangioscopy in a patient with biliary tract intraductal papillary mucinous neoplasm. VideoGIE. 4(11):517-8, 2019
                                                                                          4. Park HJ et al: Intraductal papillary neoplasm of the bile duct: clinical, imaging, and pathologic features. AJR Am J Roentgenol. 211(1):67-75, 2018
                                                                                          5. Bal MM et al: Intraductal papillary neoplasm of the bile duct: a rarity. Indian J Pathol Microbiol. 57(1):144-5, 2014
                                                                                          6. Ohtsuka M et al: Intraductal papillary neoplasms of the bile duct. Int J Hepatol. 2014:459091, 2014
                                                                                          7. Wan XS et al: Intraductal papillary neoplasm of the bile duct. World J Gastroenterol. 19(46):8595-604, 2013
                                                                                          8. Jung G et al: Long-term clinical outcome of the surgically resected intraductal papillary neoplasm of the bile duct. J Hepatol. 57(4):787-93, 2012
                                                                                          9. Rocha FG et al: Intraductal papillary neoplasm of the bile duct: A biliary equivalent to intraductal papillary mucinous neoplasm of the pancreas? Hepatology. 56(4):1352-60, 2012
                                                                                          10. Lim JH et al: Cyst-forming intraductal papillary neoplasm of the bile ducts: description of imaging and pathologic aspects. AJR Am J Roentgenol. 197(5):1111-20, 2011
                                                                                          11. Takanami K et al: Intraductal papillary mucininous neoplasm of the bile ducts: multimodality assessment with pathologic correlation. Abdom Imaging. 36(4):447-56, 2011
                                                                                          12. Takanami K et al: FDG PET/CT findings in malignant intraductal papillary mucinous neoplasm of the bile ducts. Clin Nucl Med. 35(2):83-5, 2010
                                                                                          13. Bickenbach K et al: Molecular mechanisms of cholangiocarcinogenesis: are biliary intraepithelial neoplasia and intraductal papillary neoplasms of the bile duct precursors to cholangiocarcinoma? Surg Oncol Clin N Am. 18(2):215-24, vii, 2009
                                                                                          14. Lim JH et al: Biliary intraductal papillary-mucinous neoplasm manifesting only as dilatation of the hepatic lobar or segmental bile ducts: imaging features in six patients. AJR Am J Roentgenol. 191(3):778-82, 2008
                                                                                          15. Lim JH et al: Biliary cystic intraductal papillary mucinous tumor and cystadenoma/cystadenocarcinoma: differentiation by CT. Abdom Imaging. 32(5):644-51, 2007
                                                                                          16. Zen Y et al: Biliary papillary tumors share pathological features with intraductal papillary mucinous neoplasm of the pancreas. Hepatology. 44(5):1333-43, 2006
                                                                                          17. Lim JH et al: Intraductal papillary mucinous tumor of the bile ducts. Radiographics. 24(1):53-66; discussion 66-7, 2004
                                                                                          18. Sugiyama M et al: Magnetic resonance cholangiopancreatography for postoperative follow-up of intraductal papillary-mucinous tumors of the pancreas. Am J Surg. 185(3):251-5, 2003
                                                                                          19. Oshikiri T et al: Mucin-secreting bile duct adenoma--clinicopathological resemblance to intraductal papillary mucinous tumor of the pancreas. Dig Surg. 19(4):324-7, 2002