Papillary tumors of the bile ducts are intraductal tumors with numerous minute frondlike papillary projections. Some intraductal papillary tumors of the bile ducts produce a large amount of mucin that disturbs bile flow and causes severe biliary dilatation. In the presence of a tumor of this subgroup, the entire biliary tree is dilated; segmental or lobar bile ducts are dilated disproportionately, and aneurysmal dilatation may occur. Mucin is depicted at cholangiography as multiple elongated or cordlike filling defects, and the tumor is depicted on cross-sectional images as a castlike, polypoid, or fungating mass in the dilated biliary tree. Based on these characteristic imaging features-dilatation, mucin, and tumor-correct diagnosis of intraductal papillary mucinous tumor of the bile ducts may be made.
Copyright RSNA, 2004