A subgroup of intrahepatic cholangiocarcinoma with an infiltrating replacement growth pattern and a resemblance to reactive proliferating bile ductules: ‘bile ductular carcinoma’

Kozaka, Kazuto; Sasaki, Motoko; Fujii, Tozo; Harada, Kenichi; Zen, Yoh; Sato, Yasunori; Sawada, Suguru; Minato, Hiroshi; Matsui, Osamu; Nakanuma, Yasuni

doi:10.1111/j.1365-2559.2007.02735.x

Cited by 95 publications

(95 citation statements)

References 27 publications

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“…In this study, we primarily surveyed the presence of neuroendocrine neoplasms Harada et al -9 -in hepatobiliary tumors (CC and HCC) using immunohistochemistry for chromogranin A and synaptophysin. CD56 (NCAM) is also used as a neuroendocrine marker, but biliary epithelial cells in intrahepatic small bile ducts, particularly bile ductules, and their tumors are positive for CD56 [15]. Therefore, CD56 is not suitable for the identification of neuroendocrine neoplasms in biliary tumors.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic study of mixed adenoneuroendocrine carcinomas of hepatobiliary organs

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Clinicopathologic study of mixed adenoneuroendocrine carcinomas of hepatobiliary organs

et al. 2012

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“…Recently, Komuta et al 15 reported that NCAM/CD56 was useful for classifying mixed ICCs (showing focal hepatocytic differentiation and ductular areas), which are thought to be almost the cholangiocellular subtype of combined HC-CC. Because NCAM/ CD56 and CD133, considered stem cell-related markers in the WHO classification and in several reports, [16][17][18] were frequently expressed in group B, the expression of DLK1 in stem cell HC-CC seemed to be associated with stem cell features. These markers may be important to the stem cell features of liver cancers, but it would be dangerous to make judgments based on immunohistochemical results because the expression of these markers is found in HCC, ICC, and classic-type HC-CC to various degrees.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic Significance of Combined Hepatocellular-Cholangiocarcinoma With Stem Cell Subtype Components With Reference to the Expression of Putative Stem Cell Markers

Ikeda

Harada

Sato

et al. 2013

American Journal of Clinical Pathology

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Objectives: To examine the clinicopathologic features of combined hepatocellular-cholangiocarcinoma (HC-CC), which the World Health Organization (WHO) proposed classifying into 2 types, and the expression of delta-likeSeveral markers and approaches have been used to detect and characterize hepatic stem/progenitor cells. [2][3][4][5] For example, the simultaneous immunohistochemical expression of an HCC marker (HepPar1 or a-fetoprotein [AFP]) and a biliary marker (cytokeratin [CK] 19 or carcinoembryonic antigen) has been recommended for the identification of hepatic stem/ progenitor cells in nonneoplastic and neoplastic livers, and the expression of nuclear cell adhesion molecule (NCAM/ CD56) and epithelial cell adhesion molecule (EpCAM) has been reported in small and oval-shaped stem cell-like cells. [1][2][3][4][5] Delta-like 1 homolog (DLK1) has been reported to be a biomarker of hepatic stem/progenitor cells in murine liver, because DLK1 is expressed in fetal liver, but it is restricted to a subpopulation of oval/hepatic progenitor cells in adult liver. Moreover, purified DLK1-positive cells can differentiate into both hepatocyte and biliary epithelial lineages and repopulate the normal liver in vivo after transplantation. [6][7][8] The expression of DLK1 has been reported in human fetal liver but not in normal adult liver or diseased livers with viral hepatitis and cirrhosis. 9,10 However, upregulation of DLK1 expression recently Ikeda_2012100561.indd 329

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“…ICC is composed of cells that mostly resemble those of the peripheral bile ducts, but recent reports have suggested that ICC may not always display uniform characteristics [4][5][6][7][8]. ICC can be classified into subgroups according to macroscopic findings, with clinical and pathological characteristics and prognosis differing significantly among subgroups [9,10].…”

Section: Discussionmentioning

confidence: 99%

Intrahepatic cholangiocarcinoma: relationship between tumor imaging enhancement by measuring attenuation and clinicopathologic characteristics

et al. 2012

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Purpose: Arterial enhancement of intrahepatic cholangiocarcinoma (ICC) has been noted. To precisely identify the characteristics of tumor enhancement patterns, we examined the relationship between CT attenuation in the tumor and clinicopathological parameters or prognosis.Methods: Subjects were 42 ICC patients who had undergone hepatectomy. Microvessel density (MVD) determined by CD34 staining was compared with imaging. Attenuation was calculated in images from multi-detector CT of tumor and non-tumorous regions. Enhancement patterns were divided into two groups: arterial enhancement with higher attenuation (>16 HU; Hyper group, n=12); and arterial enhancement with lower attenuation (Hypo group, n=30).Results: Univariate analysis identified high tumor marker level, increased size, less-differentiation, incomplete resection, increased bleeding and lower MVD as significantly associated with poor survival (p<0.05). Increased attenuation throughout the whole ICC correlated significantly with radiological findings and MVD. Concomitant hepatitis, well-differentiation, and smaller tumor were more significantly frequent in the Hyper group than in the Hypo group (p<0.05). Postoperative early recurrence was significantly less frequent in the Hyper group, and overall survival was significantly better in the Hyper group (p<0.05). Conclusions:Increased CT attenuation correlated with ICC tumor vascularity. Increased tumor enhancement in the arterial phase was associated with chronic hepatitis, lower malignancy and better survival.Key words: intrahepatic cholangiocarcinoma-tumor enhancement-multidetector computed tomography-prognosis-hepatectomy Nanashima et al., Page 3 Intrahepatic cholangiocarcinoma (ICC) is a well-characterized liver cancer for which various prognostic risk factors have been clarified [1][2][3]. ICC is composed of cells that mostly resemble those of the peripheral bile ducts, but recent reports have suggested that ICC may not always display uniform characteristics [4][5][6][7][8]. ICC can be classified into subgroups according to macroscopic findings, with clinical and pathological characteristics and prognosis differing significantly among subgroups [9,10].While diagnosis of the ICC subtype would be useful for predicting prognosis and determining the need for adjuvant treatments with hepatic resection, clearly distinguishing subgroups is often difficult, particularly in advanced tumors. Although a variety of prognostic parameters have been identified in recent research, the definitive factors associated with poor prognosis have not been well clarified [11,12]. Recent histological and molecular studies have revealed that tumor vascularity of ICC is closely associated with malignant behavior and patient prognosis [13,14]. Higher tumor vascularity might be related to the presence of chronic viral hepatitis, which is also related to carcinogenesis for hepatocellular carcinoma (HCC) [15]. We have previously examined histological parameters in ICC and clarified that higher tumor vascularity as dete...

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A subgroup of intrahepatic cholangiocarcinoma with an infiltrating replacement growth pattern and a resemblance to reactive proliferating bile ductules: ‘bile ductular carcinoma’

Abstract: A subgroup of peripheral CCs with an infiltrating replacement growth pattern resembles reactive bile ductules and expresses NCAM. 'Bile ductular carcinoma' may be a better term for this subgroup.

Cited by 95 publications

References 27 publications

Clinicopathologic study of mixed adenoneuroendocrine carcinomas of hepatobiliary organs

Clinicopathologic study of mixed adenoneuroendocrine carcinomas of hepatobiliary organs

Clinicopathologic Significance of Combined Hepatocellular-Cholangiocarcinoma With Stem Cell Subtype Components With Reference to the Expression of Putative Stem Cell Markers

Intrahepatic cholangiocarcinoma: relationship between tumor imaging enhancement by measuring attenuation and clinicopathologic characteristics

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