PMC4895099_01
56-year-old man with intrahepatic biliary intraductal oncocytic papillary carcinoma. Sonography of the liver demonstrates a mixed solid and cystic lesion in segment V.
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56-year-old man with intrahepatic biliary intraductal oncocytic papillary carcinoma. CT of the liver demonstrates a soft tissue lesion (arrow heads) within the cystic component.
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Computed tomography (CT) confirmed a fluid attenuation lesion with central soft tissue attenuation and intrahepatic biliary dilatation in segments V and VIII (Figure 2A, Figure 2B). CT cholangiogram failed to show contrast excretion in the dilated biliary tree. (Fig. 3) MRI and MRCP demonstrated an irregular lesion within an aneurysmally dilated focal cystic structure with an irregular solid lesion, which was intermediate signal on
56-year-old man with intrahepatic biliary intraductal oncocytic papillary carcinoma. CT of the liver demonstrates a soft tissue lesion (arrow heads) within the cystic component. Note the adjacent intrahepatic biliary dilatation (white arrow).
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56-year-old man with intrahepatic biliary intraductal oncocytic papillary carcinoma. CT cholangiogram demonstrates contrast excretion in non-dilated biliary tree and the absence of contrast in the cystic component of the lesion.
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T1 and hypointense on T2 sequences. There was negligible enhancement after dynamic intravenous gadolinium administration in all phases. (Figure 4A, Figure 4B, Figure 4C, Figure 4D, Figure 4E) On MRCP, the cystic component appeared to be in continuity with the dilated biliary tree in segments V and VIII. (Figure 5A, Figure 5B) The provisional diagnosis of intrahepatic biliary intraductal papillary neoplasm was made radiologically.
56-year-old man with intrahepatic biliary intraductal oncocytic papillary carcinoma. Axial T1-weighted MRI of the liver demonstrates the soft tissue component is of intermediate signal.
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T1 and hypointense on T2 sequences. There was negligible enhancement after dynamic intravenous gadolinium administration in all phases. (Figure 4A, Figure 4B, Figure 4C, Figure 4D, Figure 4E) On MRCP, the cystic component appeared to be in continuity with the dilated biliary tree in segments V and VIII. (Figure 5A, Figure 5B) The provisional diagnosis of intrahepatic biliary intraductal papillary neoplasm was made radiologically.
56-year-old man with intrahepatic biliary intraductal oncocytic papillary carcinoma. Coronal TSE T2-weighted MRI of the liver demonstrates the soft tissue component is hypointense on T2. Note the aneurysmally dilated cystic component communicating with adjacent dilated intrahepatic biliary tree (black arrow).
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It has a complex arborizing architecture with fibrovascular cores covered by multiple layers of oncocytic cells, forming occasional cribriform patterns. (Figure 6A, Figure 6B, Figure 6C) Marked accumulation of mucinous materials was noted. There is superficial pushing invasion of periductal stroma by papillary neoplastic cells. (Fig. 6D) The diagnosis of intrahepatic biliary intraductal oncocytic papillary carcinoma (IOPC) was made.