Intraductal papillary neoplasm of the bile duct: Cytomorphologic and molecular features Journal Article
| Authors: | Stendahl, K.; Gilani, S. M.; Basturk, O.; Hui, P.; Sigel, C.; Cai, G. |
| Article Title: | Intraductal papillary neoplasm of the bile duct: Cytomorphologic and molecular features |
| Abstract: | Background: Intraductal papillary neoplasm of the bile duct (IPNB) is a rare premalignant neoplasm that can progress to invasive adenocarcinoma. In this retrospective study, cases of IPNB were reviewed to examine cytomorphologic and molecular features. Methods: IPNB cytology cases with histopathologic confirmation were retrieved from the pathology archives. The cytomorphologic features such as cellularity, architecture, cell type, and cellular details were analyzed. Results: The cohort included 13 cases (six brushings, six fine-needle aspirations [FNA], and one combined brushing and FNA). The lesions involved common bile duct in nine cases (69%) and hepatic duct in four cases (31%). Original cytological diagnoses included adenocarcinoma (five, 38%), suspicious for adenocarcinoma (one, 8%), neoplasm (three, 23%), atypical (three, 23%), and reactive (one, 8%). The cytomorphologic features included moderate/high cellularity (12, 92%), papillary and/or complex papillary architecture (10, 77%), columnar cells (11, 85%), vacuolated cytoplasm (12, 92%), enlarged nuclei (13, 100%), and fine granular chromatin (12, 92%). Background mucin, necrosis and acute inflammation were seen in four (31%), four (31%), and two (15%) cases, respectively. KRAS testing was performed in nine cases with mutant KRAS found in five (56%). Conclusions: Our study demonstrated that IPNB cytology specimens were relatively cellular with a wide spectrum of cytomorphology; however, most cases harbored adenocarcinoma or high-grade dysplasia. The characteristic cytomorphologic features included papillary/complex papillary clusters of columnar cells with vacuolated cytoplasm, enlarged nuclei, and fine granular chromatin in relatively cellular specimens. KRAS mutations identified may have potential diagnostic and therapeutic implications. © 2022 American Cancer Society. |
| Keywords: | adult; clinical article; human tissue; aged; middle aged; retrospective studies; gene mutation; human cell; genetics; clinical feature; histopathology; case report; pancreatic neoplasms; nuclear magnetic resonance imaging; adenocarcinoma; cell structure; computer assisted tomography; cohort analysis; pathology; diagnostic imaging; retrospective study; necrosis; chromatin; pancreas tumor; bile duct neoplasms; oncogene k ras; protein p21; proto-oncogene proteins p21(ras); cytopathology; bile duct cancer; bile duct; bile ducts; mucin; molecular diagnosis; kras mutation; fine needle aspiration biopsy; fine-needle aspiration; endoscopic ultrasonography; cytomorphology; intraductal papillary neoplasm; very elderly; humans; human; male; female; article; brushing; bile duct adenocarcinoma; intraductal papillary neoplasm of the bile duct |
| Journal Title: | Cancer Cytopathology |
| Volume: | 131 |
| Issue: | 1 |
| ISSN: | 1934-662X |
| Publisher: | John Wiley & Sons |
| Date Published: | 2023-01-01 |
| Start Page: | 37 |
| End Page: | 49 |
| Language: | English |
| DOI: | 10.1002/cncy.22637 |
| PUBMED: | 36041224 |
| PROVIDER: | scopus |
| PMCID: | PMC9812877 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Carlie Sigel -- Export Date: 1 February 2023 -- Source: Scopus |
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