Simultaneous Extensive Intraductal Papillary Neoplasm of the Bile Duct and Pancreas: A Very Rare Entity

Figure 4

Micrographs. (a–c) Intraductal papillary lesions: (a) intrahepatic bile duct: IPNB with carcinoma in situ; (b) common bile duct: low-grade IPNB; and (c) main pancreatic duct: low-grade IPMN. (d–f) Invasive lesions: (d) mucin-producing tubular adenocarcinoma from invasive IPNB lesion at S4 of liver; (e, f) invasive carcinoma from distal common bile duct; (e) invading carcinoma at the duodenal wall (DW) from the intraductal lesion of the distal common bile duct (IPNB), invasive tumor at duodenal wall (), highlighted in (f) showing moderately differentiated tubular adenocarcinoma. Original magnification: (a–c) ×100, (d, f) ×200, and (e) ×40.

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