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Pathological diagnosis of flat epithelial lesions of the biliary tract with emphasis on biliary intraepithelial neoplasia

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Abstract

Flat epithelial lesions of the biliary tract cannot be detected by the image analysis, and the diagnosis entirely depends on pathological examination. The biliary tract is often affected by inflammatory conditions, and the resultant changes of the biliary epithelium make it difficult to differentiate them from neoplasia. Thus, the pathological diagnosis of biliary flat epithelial lesions can be challenging. In the biliary tract, there are several forms of intraepithelial neoplasia of the flat type, and biliary intraepithelial neoplasia (BilIN) is known as one of such lesions that represent the multistep cholangiocarcinogenesis. In this article, the diagnostic criteria and the differential diagnosis of biliary flat epithelial lesions, particularly focusing on BilIN, were presented and discussed to provide help to advance clinical and research applications of the BilIN system.

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Abbreviations

BilIN:

Biliary intraepithelial neoplasia

IPNB:

Intraductal papillary neoplasm of the bile duct

PanIN:

Pancreatic intraepithelial neoplasia

PSC:

Primary sclerosing cholangitis

WHO:

World Health Organization

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Acknowledgments

This study was supported bythe Hepatolithiasis Subdivision of Intractable Hepatobiliary Diseases Study Group of Japan (Chairman, Hirohito Tsubouchi).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Human Pathology, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8640, Japan

    Yasunori Sato, Motoko Sasaki, Kenichi Harada & Yasuni Nakanuma

  2. Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Shinichi Aishima

  3. Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan

    Toshio Fukusato

  4. Pathology Division, National Cancer Centre Research Institute, Tokyo, Japan

    Hidenori Ojima & Yae Kanai

  5. Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan

    Masayoshi Kage

  6. Department of Human and Environmental Sciences, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan

    Hirohito Tsubouchi

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  1. Yasunori Sato
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  2. Motoko Sasaki
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  9. Yasuni Nakanuma
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Hepatolithiasis Subdivision of Intractable Hepatobiliary Diseases Study Group of Japan (Chairman, Hirohito Tsubouchi)

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Correspondence to Yasuni Nakanuma.

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Sato, Y., Sasaki, M., Harada, K. et al. Pathological diagnosis of flat epithelial lesions of the biliary tract with emphasis on biliary intraepithelial neoplasia. J Gastroenterol 49, 64–72 (2014). https://doi.org/10.1007/s00535-013-0810-5

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  • DOI: https://doi.org/10.1007/s00535-013-0810-5

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