Intraductal Papillary Mucinous Tumor of the Bile Ducts: Pathologic-Radiologic Correlation

Abstract

Ziele: The objective of this paper is to describe the radiologic findings of intraductal papillary mucin-hypersecreting tumor of the bile ducts based on the surgical and pathological findings Methode: The radiologic findings of 15 cases with intraductal papillary mucinous tumor of the bile ducts were retrospectively reviewed by two radiologists and correlated with the surgical and pathologic findings. Ergebnis: Sonography (n=7), CT (n=15), MR cholangiography (n=3), endoscopic retrograde cholangiopancreatography (n=8) and percutaneous transhepatic cholagniography (n=1) revealed generalized dilatation and disproportionately more severe (n=10) or aneurysmal dilatation (n=5) of segmental or lobar bile ducts depending on the location of the tumor and the amount of mucin. Copious amounts of mucin produced elongated or linear filling defects on cholangiograms in eight cases but was not depicted on cross-sectional images. A single tumor (n=7) or multiple (n=5) tumors in bile ducts were visualized by cross sectional imaging as an intraluminal enhancing polypoid masses or intraductal cast in 12 o f15 cases. The correct diagnosis was suggested prior to surgery and histologic examination in nine patients. Schlussfolgerung: Intraductal papillary mucinous tumor of the bile duct should be considered when there is generalized and disproportionately more severe or aneurysmal dilatation of a part of the biliary tree associated with filling defects of mucin on cholangiography. The tumor can be visualized by imaging.