Clinicopathology of pancreaticobiliary maljunction: relationship between alterations in background biliary epithelium and neoplastic development |
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Authors: | Makoto Seki Akio Yanagisawa Eiji Ninomiya Yasuro Ninomiya Hirotoshi Ohta Akio Saiura Junji Yamamoto Toshiharu Yamaguchi Akiko Aruga Keiko Yamada Koichi Takano Rikiya Fujita Masayuki Ikeda Keiko Sasaki Yo Kato |
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Institution: | Department of Surgery, Cancer Institute Hospital, 1-37-1 Kami-Ikebukuro, Toshima-ku, Tokyo, 170-8455, Japan Department of Pathology, Cancer Institute Hospital, Tokyo, Japan Kasumigaseki-Building Clinic, Tokyo, Japan Department of Radiology, Cancer Institute Hospital, Tokyo, Japan Department of Internal Medicine, Cancer Institute Hospital, Tokyo, Japan
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Abstract: | Background/Purpose Between 1988 and 2003, 38 patients underwent biliary resection for pancreaticobiliary maljunction (PBM). We reviewed the histopathologic findings for the surgically resected specimens to compare the clinical and pathologic features and assess the relationship between changes in the background biliary epithelium and the development of neoplasms. Methods Papillary hyperplasia (PHP) seen in the biliary epithelium of patients with PBM, was classified into grades 0–III in the gallbladder and grades 0–II in the extrahepatic bile duct, according to the extent, and was assessed for links with tumors in the same specimens. Results The incidence of gallbladder carcinoma was 13/21 in grades I–II, versus 0/16 in grade III, while the incidence of bile duct carcinoma was 4/20 in grade I versus 0/5 in grade II. Furthermore, these incidences for patients below age 50 years and age 50 or older were 1/18 versus 12/20, and 0/14 versus 6/17, respectively. Conclusions PHP of the biliary epithelium in PBM patients is an important precursor lesion, especially for gallbladder cancer, and the risk becomes greater with age, regardless of the type of pancreatobiliary junction (PBJ) and its location in the biliary tract. |
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Keywords: | pancreaticobiliary maljunction (PBM) clinicopathology of PBM neoplasia papillary hyperplasia |
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