Clinicopathological features and literature review of intraductal oncocytic papillary neoplasm in the intrahepatic bile duct
Objective:To investigate the clinical characteristics,histopathological manifestation,immunophenotype and differential diagnosis of intraductal oncocytic papillary neoplasm(IOPN)in the intrahepatic bile duct.Methods:The clinicopathological characteristics were analyzed retrospectively in one case of IOPN.Immunohistochemistry was used to detect the expression of AE1/AE3,EMA,MUC1,MUC2,MUC5 AC,MUC6,AFP,HepPar-1,CA199,CDX-2,CK19,CK7,CK20,p53 and Ki-67 in IOPN,and related literatures were reviewed.Results:The patient was a 55-year-old male.CT revealed a cystic space occupying lesion in the left inner lobe of the liver.The size of the cyst was approximately 8.0 cm×8.0 cm×3.0 cm.Microscopy exposed that the tumor tissue was located within the cyst cavity,with inexplicitly defined boundary between the tumor and surrounding tissues,and grew in a papillary structure.Tumor cells showed relatively consistent size,with round or oval nuclei,mild-moderate heteromorphism,rough chromatin,and small nucleoli.No pathological mitosis was observed.The cytoplasm of tumor cells was abundant and eosinophilic granules were visible.Tumor cells invaded the focal cyst wall.Immunohistochemical markers showed positive expression of AE1/AE3,EMA,MUC6,HepPar-1,CK19 and CK7 on tumor cells.MUC1 was positively expressed in individual tumor cells,and MUC5AC was positively expressed in partial tumor cells.p53 was in wild type.MUC2,AFP,CA199,CDX-2 and CK20 were all negatively expressed on tumor cells.Conclusion:Intrahepatic IOPN is a rare primary liver growth,for which clinical and imaging examinations can not provide a definitive diagnosis and must be differentiated from various tumors.Final confirmation relies on histomorphological findings and immunophenotypes.The primary treatment depends on surgical resection,with good prognosis in non-invasive cases and a higher recurrence risk in invasive types.
intrahepatic bile ductintraductal oncocytic papillary neoplasmimmunophenotypepathological diagnosisdifferential diagnosis