Abstract
Background : Intraductal papillary neoplasm of the bile duct (IPNB) is a tumor histologically similar to intraductal papillary mucinous neoplasm of the pancreas (IPMN-P), but there are few reports about the characteristic cytological findings. We report the cytological findings of IPNB without macroscopic mucin production.
Case : A 61-year-old woman was detected to have a papillary tumor of the bile duct with hepatolithiasis, and right hepatic lobectomy was performed. Bile and imprint cytology showed granular or foamy change of the cytoplasm of the cells. The nuclei showed ununiformity, nuclear shape irregularity, and uneven distribution of nucleus. The nuclear chromatin was fine and granular, and clear nucleoli were seen. There was no mucinous background. Macroscopically, the tumor was confined to the bile duct, and there was no evidence of viscous fluid retention. Microscopically, the atypical cells were mainly arranged in a papillary pattern. The atypical cells also showed dyskaryotic changes, such as nuclear swelling, nuclear shape irregularity, and nucleolar clarification.
Conclusion : We suggest that to make a diagnosis of IPNB without macroscopic mucin production, it is important to observe papillary clusters and the nuclear arrangement, nuclear form, and nuclear chromatin using the “Diagnostic bile cytology criteria”.
