Pathologic features of mucin-producing bile duct tumors - Two histopathologic categories as counterparts of pancreatic intraductal papillary-mucinous neoplasms
Pathologic features of mucin-producing bile duct tumors - Two histopathologic categories as counterparts of pancreatic intraductal papillary-mucinous neoplasms
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DOI：
10.1097/00000478-200403000-00005
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发表时间：
2004-03-01
影响因子：
5.6
通讯作者：
Yonezawa, S
中科院分区：
文献类型：
--
作者：
Shibahara, H;Tamada, S;Yonezawa, S
临床上可识别的来自胆管的产生粘蛋白的肿瘤，即“产生粘蛋白的胆管肿瘤（MPBTs）”，尚未对其病理特征和分类进行详细研究。MPBT的临床表现与胰腺导管内乳头状黏液性肿瘤有许多相似之处。在本研究中，我们检查了30例MPBT，并将其分为两种不同的形态学类型：22例由嗜碱性细胞质和柱状核的假复层柱状细胞组成的“柱状型”和8例由胰胆和/或嗜酸细胞模式组成的“立方型”。胰胆管型表现为乳头内有大量分支，乳头内排列着嗜酸性立方细胞，细胞核呈圆形;嗜酸细胞型表现为上皮内管腔和由大量嗜酸性细胞组成的筛状结构，细胞核呈圆形，两者经常重叠。柱状型和立方型之间的临床病理特征包括大体表现、形态计量学数据、粘蛋白表达谱（柱状型中MUC 2表达和立方型中MUC 6表达）以及细胞增殖活性存在显著差异。柱状型患者的生存率明显低于立方型患者。我们认为柱状型和立方型MBPT属于不同的肿瘤谱系，它们分别对应于胰腺导管内乳头状黏液性肿瘤的“肠型”和“胰胆型”。
Tumors with clinically recognizable mucin production arising from bile duct, "mucin-producing bile duct tumors (MPBTs)," have not been studied yet for their pathologic features and classification in details. The clinical findings of MPBT have a lot of similarities to those of pancreatic intraductal papillary-mucinous neoplasm. In the present study, we examined 30 MPBTs and classified them into two distinct morphologic categories: 22 cases of "columnar type" composed of pseudostratified columnar cells with basophilic cytoplasm and columnar nuclei and 8 cases of "cuboidal type" composed of pancreaticobiliary and/or oncocytic pattern. Pancreaticobiliary pattern showed abundantly branched papillae lined by acidophilic cuboidal cells with round nuclei, whereas oncocytic pattern was characterized by intraepithelial lumina and cribriform pattern composed of abundant oxyphilic cells with round nuclei, and these patterns overlapped frequently. There were significant differences in the clinicopathologic findings including macroscopic findings, morphometric data, mucin expression profiles (MUC2 expression in columnar type and MUC6 expression in cuboidal type), and cell proliferative activities between columnar type and cuboidal type. Patients with columnar type showed significantly poorer survival than those with cuboidal type. We concluded that columnar type and cuboidal type of MBPTs belong to different lineage of neoplasm and that they are counterparts of "intestinal type" and "pancreaticobiliary type" of pancreatic intraductal papillary-mucinous neoplasm, respectively.