Peribiliary glands: development, dysfunction, related conditions and imaging findings

  • Takashi Matsubara
  • Kazuto KozakaEmail author
  • Osamu Matsui
  • Yasuni Nakanuma
  • Katsuhiko Uesaka
  • Dai Inoue
  • Norihide Yoneda
  • Kotaro Yoshida
  • Azusa Kitao
  • Akira Yokka
  • Wataru Koda
  • Toshifumi Gabata
  • Satoshi Kobayashi


Peribiliary glands are minute structures that are distributed along the intrahepatic large bile ducts, extrahepatic bile duct, and cystic duct. These glands regulate many physiological functions, such as enzyme secretion. Pancreatic exocrine tissues and enzymes are often observed in peribiliary glands; thus, peribiliary glands are involved in enzyme secretion. As such, these glands can be affected by conditions such as IgG4-related sclerosing cholangitis based on commonalities with their pancreatic counterparts. Cystic changes in peribiliary glands can occur de novo, as part of a congenital syndrome, or secondary to insults such as alcoholic cirrhosis. Biliary tree stem/progenitor cells have recently been identified in peribiliary glands. These cells are involved in turnover and regeneration of biliary epithelia as well as in sclerosing reactions in some pathological conditions, such as primary sclerosing cholangitis and hepatolithiasis. Notably, hepatolithiasis is involved in mucin secretion by the peribiliary glands. Additionally, these cells are associated with the manifestation of several neoplasms, including intraductal papillary neoplasm, cystic micropapillary neoplasm, and cholangiocarcinoma. Normal peribiliary glands themselves are particularly small structures that cannot be recognized using any available imaging modalities; however, these glands are closely associated with several diseases, as mentioned above, which have typical imaging features. Therefore, knowledge of the basic pathophysiology of peribiliary glands is helpful for understanding biliary diseases associated with the peribiliary glands.


Peribiliary gland Computed tomography Magnetic resonance imaging Magnetic resonance cholangiopancreatography Bile duct neoplasms Sclerosing cholangitis 



We thank Angela Morben, DVM, ELS, from Edanz Group ( for editing a draft of this manuscript.


  1. 1.
    Carpino G, Renzi A, Franchitto A, Cardinale V, Onori P, Reid L, Alvaro D, Gaudio E. Stem/Progenitor Cell Niches Involved in Hepatic and Biliary Regeneration. Stem Cells Int 2016;2016:3658013. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Nakanuma Y, Katayanagi K, Terada T, Saito K. Intrahepatic peribiliary glands of humans. I. Anatomy, development and presumed functions. J Gastroenterol Hepatol 1994;9(1):75-79.
  3. 3.
    Nakanuma Y. A novel approach to biliary tract pathology based on similarities to pancreatic counterparts: is the biliary tract an incomplete pancreas? Pathol Int 2010;60(6):419-429. CrossRefPubMedGoogle Scholar
  4. 4.
    Ishida F, Terada T, Nakanuma Y. Histologic and scanning electron microscopic observations of intrahepatic peribiliary glands in normal human livers. Lab Invest 1989;60(2):260-265.
  5. 5.
    Sato H, Nakanuma Y, Kozaka K, Sato Y, Ikeda H. Spread of hilar cholangiocarcinomas via peribiliary gland network: a hither-to-unrecognized route of periductal infiltration. Int J Clin Exp Pathol 2013;6(2):318-322.
  6. 6.
    Cardinale V, Wang Y, Carpino G, Cui CB, Gatto M, Rossi M, Berloco PB, Cantafora A, Wauthier E, Furth ME, Inverardi L, Dominguez-Bendala J, Ricordi C, Gerber D, Gaudio E, Alvaro D, Reid L. Multipotent stem/progenitor cells in human biliary tree give rise to hepatocytes, cholangiocytes, and pancreatic islets. Hepatology 2011;54(6):2159-2172. CrossRefPubMedGoogle Scholar
  7. 7.
    Carpino G, Cardinale V, Renzi A, Hov JR, Berloco PB, Rossi M, Karlsen TH, Alvaro D, Gaudio E. Activation of biliary tree stem cells within peribiliary glands in primary sclerosing cholangitis. J Hepatol 2015;63(5):1220-1228. CrossRefPubMedGoogle Scholar
  8. 8.
    Terada T, Nakanuma Y. Immunohistochemical demonstration of pancreatic alpha-amylase and trypsin in intrahepatic bile ducts and peribiliary glands. Hepatology 1991;14(6):1129-1135. doi: S0270913991003130 [pii]Google Scholar
  9. 9.
    Oikawa T. Cancer Stem cells and their cellular origins in primary liver and biliary tract cancers. Hepatology 2016;64(2):645-651. CrossRefPubMedGoogle Scholar
  10. 10.
    Terada T. Development of extrahepatic bile duct excluding gall bladder in human fetuses: histological, histochemical, and immunohistochemical analysis. Microsc Res Tech 2014;77(10):832-840. CrossRefPubMedGoogle Scholar
  11. 11.
    Matsubara T, Sato Y, Igarashi S, Matsui O, Gabata T, Nakanuma Y. Alcohol-related injury to peribiliary glands is a cause of peribiliary cysts: based on analysis of clinical and autopsy cases. J Clin Gastroenterol 2014;48(2):153-159. CrossRefPubMedGoogle Scholar
  12. 12.
    Nakanuma Y, Sasaki M, Terada T, Harada K. Intrahepatic peribiliary glands of humans. II. Pathological spectrum. J Gastroenterol Hepatol 1994;9(1):80-86.
  13. 13.
    Nakanuma Y. Peribiliary cysts have at least two different pathogeneses. J Gastroenterol 2004;39(4):407-408. CrossRefPubMedGoogle Scholar
  14. 14.
    Kida T, Nakanuma Y, Terada T. Cystic dilatation of peribiliary glands in livers with adult polycystic disease and livers with solitary nonparasitic cysts: an autopsy study. Hepatology 1992;16(2):334-340.
  15. 15.
    Qian Q, Li A, King BF, Kamath PS, Lager DJ, Huston J, 3rd, Shub C, Davila S, Somlo S, Torres VE. Clinical profile of autosomal dominant polycystic liver disease. Hepatology 2003;37(1):164-171. CrossRefPubMedGoogle Scholar
  16. 16.
    Terayama N, Matsui O, Hoshiba K, Kadoya M, Yoshikawa J, Gabata T, Takashima T, Terada T, Nakanuma Y, Shinozaki K, et al. Peribiliary cysts in liver cirrhosis: US, CT, and MR findings. J Comput Assist Tomogr 1995;19(3):419-423.
  17. 17.
    Terada T, Minato H, Nakanuma Y, Shinozaki K, Kobayashi S, Matsui O. Ultrasound visualization of hepatic peribiliary cysts: a comparison with morphology. Am J Gastroenterol 1992;87(10):1499-1502.
  18. 18.
    Motoo Y, Yamaguchi Y, Watanabe H, Okai T, Sawabu N. Hepatic peribiliary cysts diagnosed by magnetic resonance cholangiography. J Gastroenterol 2001;36(4):271-275. Scholar
  19. 19.
    Baron RL, Campbell WL, Dodd GD, 3rd. Peribiliary cysts associated with severe liver disease: imaging-pathologic correlation. AJR Am J Roentgenol 1994;162(3):631-636. CrossRefPubMedGoogle Scholar
  20. 20.
    Itai Y, Ebihara R, Eguchi N, Saida Y, Kurosaki Y, Minami M, Araki T. Hepatobiliary cysts in patients with autosomal dominant polycystic kidney disease: prevalence and CT findings. AJR Am J Roentgenol 1995;164(2):339-342. CrossRefPubMedGoogle Scholar
  21. 21.
    Tanaka A. IgG4-Related Sclerosing Cholangitis and Primary Sclerosing Cholangitis. Gut and liver 2019;13(3):300-307. CrossRefPubMedGoogle Scholar
  22. 22.
    Ruemmele P, Hofstaedter F, Gelbmann CM. Secondary sclerosing cholangitis. Nature Reviews Gastroenterology and Hepatology 2009;6(5):287-295.CrossRefGoogle Scholar
  23. 23.
    Lazaridis KN, LaRusso NF. Primary Sclerosing Cholangitis. N Engl J Med 2016;375(12):1161-1170. CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Karlsen TH, Schrumpf E, Boberg KM. Primary sclerosing cholangitis. Best Pract Res Clin Gastroenterol 2010;24(5):655-666. CrossRefPubMedGoogle Scholar
  25. 25.
    BC P, Y N. Diseases of bile ducts. London: Churchill Livingstone, 2006: 517-581.Google Scholar
  26. 26.
    Terasaki S, Nakanuma Y, Unoura M, Kaneko S, Kobayashi K. Involvement of peribiliary glands in primary sclerosing cholangitis: a histopathologic study. Intern Med 1997;36(11):766-770.
  27. 27.
    Zen Y, Quaglia A, Heaton N, Rela M, Portmann B. Two distinct pathways of carcinogenesis in primary sclerosing cholangitis. Histopathology 2011;59(6):1100-1110. CrossRefPubMedGoogle Scholar
  28. 28.
    Carpino G, Cardinale V, Renzi A, Hov JR, Berloco PB, Rossi M, Karlsen TH, Alvaro D, Gaudio E. Activation of biliary tree stem cells within peribiliary glands in primary sclerosing cholangitis. Journal of hepatology 2015;63(5):1220-1228.CrossRefGoogle Scholar
  29. 29.
    Umehara H, Okazaki K, Masaki Y, Kawano M, Yamamoto M, Saeki T, Matsui S, Yoshino T, Nakamura S, Kawa S, Hamano H, Kamisawa T, Shimosegawa T, Shimatsu A, Nakamura S, Ito T, Notohara K, Sumida T, Tanaka Y, Mimori T, Chiba T, Mishima M, Hibi T, Tsubouchi H, Inui K, Ohara H. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol 2012;22(1):21-30. CrossRefPubMedGoogle Scholar
  30. 30.
    Zen Y, Kawakami H, Kim JH. IgG4-related sclerosing cholangitis: all we need to know. J Gastroenterol 2016;51(4):295-312. CrossRefPubMedGoogle Scholar
  31. 31.
    Inoue D, Yoshida K, Yoneda N, Ozaki K, Matsubara T, Nagai K, Okumura K, Toshima F, Toyama J, Minami T. IgG4-Related Disease: Dataset of 235 Consecutive Patients. Medicine 2015;94(15):e680.CrossRefGoogle Scholar
  32. 32.
    Majoie CB, Reeders JW, Sanders JB, Huibregtse K, Jansen PL. Primary sclerosing cholangitis: a modified classification of cholangiographic findings. AJR Am J Roentgenol 1991;157(3):495-497. CrossRefPubMedGoogle Scholar
  33. 33.
    Nakazawa T, Naitoh I, Hayashi K, Miyabe K, Simizu S, Joh T. Diagnosis of IgG4-related sclerosing cholangitis. World J Gastroenterol 2013;19(43):7661-7670. CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ, American Association for the Study of Liver D. Diagnosis and management of primary sclerosing cholangitis. Hepatology 2010;51(2):660-678. CrossRefGoogle Scholar
  35. 35.
    Dave M, Elmunzer BJ, Dwamena BA, Higgins PD. Primary Sclerosing Cholangitis: Meta-Analysis of Diagnostic Performance of MR Cholangiopancreatography 1. Radiology 2010;256(2):387-396.CrossRefGoogle Scholar
  36. 36.
    Aabakken L, Karlsen TH, Albert J, Arvanitakis M, Chazouilleres O, Dumonceau J-m, Färkkilä M, Fickert P, Hirschfield GM, Laghi A. Clinical Practice Guidelines Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) Clinical Guideline q Clinical Practice Guidelines. 2017.Google Scholar
  37. 37.
    Liver EAFTSOT. EASL Clinical Practice Guidelines: management of cholestatic liver diseases. Journal of hepatology 2009;51(2):237-267.Google Scholar
  38. 38.
    Tokala A, Khalili K, Menezes R, Hirschfield G, Jhaveri KS. Comparative MRI analysis of morphologic patterns of bile duct disease in IgG4-related systemic disease versus primary sclerosing cholangitis. AJR Am J Roentgenol 2014;202(3):536-543. CrossRefPubMedGoogle Scholar
  39. 39.
    Kim JH, Byun JH, Kim SY, Lee SS, Kim HJ, Kim MH, Lee MG. Sclerosing cholangitis with autoimmune pancreatitis versus primary sclerosing cholangitis: comparison on endoscopic retrograde cholangiography, MR cholangiography, CT, and MRI. Acta Radiol 2013;54(6):601-607. CrossRefPubMedGoogle Scholar
  40. 40.
    Zen Y, Sasaki M, Fujii T, Chen TC, Chen MF, Yeh TS, Jan YY, Huang SF, Nimura Y, Nakanuma Y. Different expression patterns of mucin core proteins and cytokeratins during intrahepatic cholangiocarcinogenesis from biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct--an immunohistochemical study of 110 cases of hepatolithiasis. J Hepatol 2006;44(2):350-358. CrossRefPubMedGoogle Scholar
  41. 41.
    Hsu M, Sasaki M, Igarashi S, Sato Y, Nakanuma Y. KRAS and GNAS mutations and p53 overexpression in biliary intraepithelial neoplasia and intrahepatic cholangiocarcinomas. Cancer 2013;119(9):1669-1674. CrossRefPubMedGoogle Scholar
  42. 42.
    Igarashi S, Sato Y, Ren XS, Harada K, Sasaki M, Nakanuma Y. Participation of peribiliary glands in biliary tract pathophysiologies. World J Hepatol 2013;5(8):425-432. CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Gabata T, Kadoya M, Matsui O, Kobayashi T, Sanada J, Mori A. Intrahepatic biliary calculi: correlation of unusual MR findings with pathologic findings. Abdom Imaging 2000;25(3):266-268.
  44. 44.
    Safar F, Kamura T, Okamuto K, Sasai K, Gejyo F. Magnetic resonance T1 gradient-echo imaging in hepatolithiasis. Abdom Imaging 2005;30(3):297-302. CrossRefPubMedGoogle Scholar
  45. 45.
    Park HS, Lee JM, Kim SH, Jeong JY, Kim YJ, Lee KH, Choi SH, Han JK, Choi BI. CT Differentiation of cholangiocarcinoma from periductal fibrosis in patients with hepatolithiasis. AJR Am J Roentgenol 2006;187(2):445-453. doi: 187/2/445 [pii]. 10.2214/AJR.05.0247Google Scholar
  46. 46.
    Chung YE, Kim MJ, Park YN, Lee YH, Choi JY. Staging of extrahepatic cholangiocarcinoma. Eur Radiol 2008;18(10):2182-2195. CrossRefPubMedGoogle Scholar
  47. 47.
    Khan SA, Thomas HC, Davidson BR, Taylor-Robinson SD. Cholangiocarcinoma. Lancet 2005;366(9493):1303-1314. CrossRefPubMedGoogle Scholar
  48. 48.
    Nakagawa H, Hayata Y, Yamada T, Kawamura S, Suzuki N, Koike K. Peribiliary Glands as the Cellular Origin of Biliary Tract Cancer. International journal of molecular sciences 2018;19(6):1745.CrossRefGoogle Scholar
  49. 49.
    Nakanuma Y, Kakuda Y. Pathologic classification of cholangiocarcinoma: New concepts. Best Pract Res Clin Gastroenterol 2015;29(2):277-293. CrossRefPubMedGoogle Scholar
  50. 50.
    Nakanuma Y, Miyata T, Uchida T. Latest advances in the pathological understanding of cholangiocarcinomas. Expert Rev Gastroenterol Hepatol 2016;10(1):113-127. CrossRefPubMedGoogle Scholar
  51. 51.
    Nakanuma Y, Curado M-P, Franceschi S, Gores G, Paradis V, Sripa B, Tsui WMS, Wee A. Intrahepatic cholangiocarcinoma. 4 ed. Lyon: IARC, 2010: 217-224.Google Scholar
  52. 52.
    Zen Y, Adsay NV, Bardadin K, Colombari R, Ferrell L, Haga H, Hong S-M, Hytiroglou P, Klöppel G, Lauwers GY. Biliary intraepithelial neoplasia: an international interobserver agreement study and proposal for diagnostic criteria. Modern pathology 2007;20(6):701-709.CrossRefGoogle Scholar
  53. 53.
    Strobel O, Rosow DE, Rakhlin EY, Lauwers GY, Trainor AG, Alsina J, Fernandez-Del Castillo C, Warshaw AL, Thayer SP. Pancreatic duct glands are distinct ductal compartments that react to chronic injury and mediate Shh-induced metaplasia. Gastroenterology 2010;138(3):1166-1177. CrossRefPubMedGoogle Scholar
  54. 54.
    Yamaguchi J, Yokoyama Y, Kokuryo T, Ebata T, Nagino M. Cells of origin of pancreatic neoplasms. Surg Today 2017. CrossRefPubMedGoogle Scholar
  55. 55.
    Nakanuma Y, Basturk O, Esposito I, Klimstra D, Komuta M, Zen Y. Intraductal papillary neoplasm of the bile ducts. In: Lokuhetty D, White V, Watanabe R, Cree I, eds. WHO classification of tumours Digestive System Tumours. 5 ed. Lyon: IARC, 2019; p. 279-282.Google Scholar
  56. 56.
    Zen Y, Fujii T, Itatsu K, Nakamura K, Konishi F, Masuda S, Mitsui T, Asada Y, Miura S, Miyayama S, Uehara T, Katsuyama T, Ohta T, Minato H, Nakanuma Y. Biliary cystic tumors with bile duct communication: a cystic variant of intraductal papillary neoplasm of the bile duct. Mod Pathol 2006;19(9):1243-1254. CrossRefPubMedGoogle Scholar
  57. 57.
    Nakanishi Y, Nakanuma Y, Ohara M, Iwao T, Kimura N, Ishidate T, Kijima H. Intraductal papillary neoplasm arising from peribiliary glands connecting with the inferior branch of the bile duct of the anterior segment of the liver. Pathol Int 2011;61(12):773-777. CrossRefPubMedGoogle Scholar
  58. 58.
    Nakanuma Y, Sato Y. Cystic and papillary neoplasm involving peribiliary glands: a biliary counterpart of branch-type intraductal papillary mucinous [corrected] neoplasm? Hepatology 2012;55(6):2040-2041. CrossRefPubMedGoogle Scholar
  59. 59.
    Lim JH, Zen Y, Jang KT, Kim YK, Nakanuma Y. Cyst-forming intraductal papillary neoplasm of the bile ducts: description of imaging and pathologic aspects. AJR Am J Roentgenol 2011;197(5):1111-1120. CrossRefPubMedGoogle Scholar
  60. 60.
    Sato Y, Harada K, Sasaki M, Nakanuma Y. Cystic and micropapillary epithelial changes of peribiliary glands might represent a precursor lesion of biliary epithelial neoplasms. Virchows Arch 2014;464(2):157-163. CrossRefPubMedGoogle Scholar
  61. 61.
    Uchida T, Yamamoto Y, Ito T, Okamura Y, Sugiura T, Uesaka K, Nakanuma Y. Cystic micropapillary neoplasm of peribiliary glands with concomitant perihilar cholangiocarcinoma. World J Gastroenterol 2016;22(7):2391-2397. CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Katabathina VS, Flaherty EM, Dasyam AK, Menias CO, Riddle ND, Lath N, Kozaka K, Matsui O, Nakanuma Y, Prasad SR. “Biliary Diseases with Pancreatic Counterparts”: Cross-sectional Imaging Findings. Radiographics 2016;36(2):374-392. CrossRefPubMedGoogle Scholar
  63. 63.
    Nakanuma Y. Pre-invasive intraductal papillary neoplasm of the pancreatobiliary system. Clin Res Hepatol Gastroenterol 2016.Google Scholar
  64. 64.
    Nakanuma Y. Pre-invasive intraductal papillary neoplasm of the pancreatobiliary system. Clin Res Hepatol Gastroenterol 2016;40(2):133-135. CrossRefPubMedGoogle Scholar
  65. 65.
    Nakanuma Y, Harada K, Sasaki M, Sato Y. Proposal of a new disease concept “biliary diseases with pancreatic counterparts”. Anatomical and pathological bases. Histol Histopathol 2014;29(1):1-10. CrossRefPubMedGoogle Scholar
  66. 66.
    Yamaguchi J, Mino-Kenudson M, Liss AS, Chowdhury S, Wang TC, Fernandez-Del Castillo C, Lillemoe KD, Warshaw AL, Thayer SP. Loss of Trefoil Factor 2 From Pancreatic Duct Glands Promotes Formation of Intraductal Papillary Mucinous Neoplasms in Mice. Gastroenterology 2016;151(6):1232-1244 e1210. CrossRefGoogle Scholar
  67. 67.
    Ayuso JR, Pages M, Darnell A. Imaging bile duct tumors: staging. Abdom Imaging 2013;38(5):1071-1081. CrossRefPubMedGoogle Scholar
  68. 68.
    Yamada Y, Mori H, Hijiya N, Matsumoto S, Takaji R, Kiyonaga M, Ohta M, Kitano S, Moriyama M, Takaki H, Fukuzawa K, Yonemasu H. Extrahepatic bile duct cancer: invasion of the posterior hepatic plexuses--evaluation using multidetector CT. Radiology 2012;263(2):419-428. CrossRefPubMedGoogle Scholar
  69. 69.
    Ochotorena IJ, Kiyosue H, Hori Y, Yokoyama S, Yoshida T, Mori H. The local spread of lower bile duct cancer: evaluation by thin-section helical CT. Eur Radiol 2000;10(7):1106-1113. CrossRefPubMedGoogle Scholar
  70. 70.
    Takanami K, Yamada T, Tsuda M, Takase K, Ishida K, Nakamura Y, Kanno A, Shimosegawa T, Unno M, Takahashi S. Intraductal papillary mucininous neoplasm of the bile ducts: multimodality assessment with pathologic correlation. Abdom Imaging 2011;36(4):447-456. CrossRefGoogle Scholar
  71. 71.
    Zen Y, Pedica F, Patcha VR, Capelli P, Zamboni G, Casaril A, Quaglia A, Nakanuma Y, Heaton N, Portmann B. Mucinous cystic neoplasms of the liver: a clinicopathological study and comparison with intraductal papillary neoplasms of the bile duct. Mod Pathol 2011;24(8):1079-1089. CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Ogawa H, Itoh S, Nagasaka T, Suzuki K, Ota T, Naganawa S. CT findings of intraductal papillary neoplasm of the bile duct: assessment with multiphase contrast-enhanced examination using multi-detector CT. Clin Radiol 2012;67(3):224-231. CrossRefPubMedGoogle Scholar
  73. 73.
    Yoon HJ, Kim YK, Jang KT, Lee KT, Lee JK, Choi DW, Lim JH. Intraductal papillary neoplasm of the bile ducts: description of MRI and added value of diffusion-weighted MRI. Abdom Imaging 2013;38(5):1082-1090. CrossRefPubMedGoogle Scholar
  74. 74.
    Kim JE, Lee JM, Kim SH, Baek JH, Moon SK, Yu IS, Kim SH, Lee JY, Han JK, Choi BI. Differentiation of intraductal growing-type cholangiocarcinomas from nodular-type cholangiocarcinomas at biliary MR imaging with MR cholangiography. Radiology 2010;257(2):364-372. CrossRefPubMedGoogle Scholar
  75. 75.
    Katabathina VS, Dasyam AK, Dasyam N, Hosseinzadeh K. Adult bile duct strictures: role of MR imaging and MR cholangiopancreatography in characterization. Radiographics 2014;34(3):565-586. CrossRefPubMedGoogle Scholar
  76. 76.
    Kamisawa T, Nakazawa T, Tazuma S, Zen Y, Tanaka A, Ohara H, Muraki T, Inui K, Inoue D, Nishino TJJoHBPS. Clinical practice guidelines for IgG4-related sclerosing cholangitis. 2018.Google Scholar
  77. 77.
    Harada K, Shimoda S, Kimura Y, Sato Y, Ikeda H, Igarashi S, Ren XS, Sato H, Nakanuma Y. Significance of IgG4-positive cells in extrahepatic cholangiocarcinoma: Molecular mechanism of IgG4 reaction in cancer tissue. Hepatology 2012. CrossRefPubMedGoogle Scholar
  78. 78.
    Yata M, Suzuki K, Furuhashi N, Kawakami K, Kawai Y, Naganawa S. Comparison of the multidetector-row computed tomography findings of IgG4-related sclerosing cholangitis and extrahepatic cholangiocarcinoma. Clin Radiol 2016;71(3):203-210. CrossRefPubMedGoogle Scholar
  79. 79.
    Maeda E, Akahane M, Yoshioka N, Takao H, Matsuda I, Kamiya K, Hirano K, Tada M, Ohtsu H, Fukushima N, Ohtomo K. Comparison of CT findings of biliary tract changes with autoimmune pancreatitis and extrahepatic bile duct cholangiocarcinoma. Jpn J Radiol 2012;30(3):227-234. CrossRefPubMedGoogle Scholar

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Authors and Affiliations

  1. 1.Department of RadiologyKanazawa University Graduate School of Medical SciencesKanazawaJapan
  2. 2.Department of RadiologyFukui Prefectural HospitalFukuiJapan
  3. 3.Department of Diagnostic PathologyFukui Saiseikai HospitalFukuiJapan
  4. 4.Division of Hepato-Billiary-Pancreatic SurgeryShizuoka Cancer CenterShizuokaJapan
  5. 5.Department of Radiological Technology, School of Health Sciences, College of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaJapan

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