Cholangiocarcinoma: classification, diagnosis, staging, imaging features, and management

Oliveira, Irai S.; Kilcoyne, Aoife; Everett, Jamie; Mino‐Kenudson, Mari; Harisinghani, Mukesh G.; Ganesan, Karthik

doi:10.1007/s00261-017-1094-7

Cited by 95 publications

(77 citation statements)

References 60 publications

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“…11,14 Anatomically, iCCA is defined as a malignancy located in the periphery of the second-order bile ducts; thus it can arise from segmental bile ducts to smaller branches of the intrahepatic biliary tree. 11 pCCA arises in the right and/or left hepatic duct and/or at their junction 15 ; it is clinically also known as Klatskin tumour, 16 although this term should be discouraged. dCCA involves the common bile duct.…”

Section: Anatomical Classification Of Cca Gross Morphology and Gromentioning

confidence: 99%

Anatomical, histomorphological and molecular classification of cholangiocarcinoma

Kendall

Verheij

Gaudio

et al. 2019

Liver International

221

190

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Cholangiocarcinoma constitutes a heterogeneous group of malignancies that can emerge at any point of the biliary tree. Cholangiocarcinoma is classified into intrahepatic, perihilar and distal based on its anatomical location. Histologically, conventional perihilar/distal cholangiocarcinomas are mucin‐producing adenocarcinomas or papillary tumours; intrahepatic cholangiocarcinomas are more heterogeneous and can be sub‐classified according to the level or size of the displayed bile duct. Cholangiocarcinoma develops through multistep carcinogenesis and is preceded by dysplastic and in situ lesions. Definition and clinical significance of precursor lesions, including biliary intraepithelial neoplasia, intraductal papillary neoplasms of the bile duct, intraductal tubulopapillary neoplasms and mucinous cystic neoplasm, are discussed in this review. A main challenge in diagnosing cholangiocarcinoma is the fact that tumour tissue for histological examination is difficult to obtain. Thus, a major clinical obstacle is the establishment of the correct diagnosis at a tumour stage that is amenable to surgery which still represents the only curable therapeutic option. Current standards, methodology and criteria for diagnosis are discussed. Cholangiocarcinoma represents a heterogeneous tumour with regard to molecular alterations. In intrahepatic subtype, mainly two distinctive morpho‐molecular groups can currently be discriminated. Large‐duct type intrahepatic cholangiocarcinoma shows a high mutation frequency of oncogenes and tumour suppressor genes, such as KRAS and TP53 while Isocitrate Dehydrogenase 1/2 mutations and Fibroblast Growth Factor Receptor 2‐fusions are typically seen in small‐duct type tumours. It is most important to ensure the separation of the given anatomical subtypes and to search for distinct subgroups within the subtypes on a molecular and morphological basis.

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Section: Anatomical Classification Of Cca Gross Morphology and Gromentioning

confidence: 99%

Anatomical, histomorphological and molecular classification of cholangiocarcinoma

Kendall

Verheij

Gaudio

et al. 2019

Liver International

221

190

View full text Add to dashboard Cite

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“…In patients suspected of having CC, imaging plays a critical role in diagnosis and treatment planning (71,72). Since surgical complete resection is the only potentially curative treatment option, selection of the most appropriate surgical candidates and determination of the type and extent of surgery for the selected candidates are the primary goals of imaging.…”

Section: Role Of Imagingmentioning

confidence: 99%

Imaging Diagnosis of Intrahepatic and Perihilar Cholangiocarcinoma: Recent Advances and Challenges

2018

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Cholangiocarcinoma, the second most common hepatobiliary malignancy after hepatocellular carcinoma, is a heterogeneous disease entity with widely varying radiologic features, clinical behavior, and treatment approaches. In the detection, characterization, staging, and resectability assessment of cholangiocarcinoma, imaging studies are indispensable. Herein, an overview of the state-of-the-art imaging techniques is presented for the evaluation of intrahepatic and perihilar cholangiocarcinoma, as well as complementary multimodality and multiparametric imaging approaches for a more comprehensive evaluation. In addition, classification systems, new pathologic concepts in cholangiocarcinogenesis and premalignant lesions, and current trends in treatment approaches, which are vital to the imaging interpretation of cholangiocarcinoma, will be discussed. RSNA, 2018.

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“…Based on the anatomical site, CCAs is classified in two major groups: intrahepatic (iCCA) and extrahepatic (eCCA) CCA [5]. The iCCA is located in the intrahepatic biliary tree [5,6] whereas eCCA may rise in the extrahepatic bile ducts [7,8]. CCA is characterized by very poor outcome, showing an increase in incidence and mortality rate worldwide [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Multifaceted Aspects of Metabolic Plasticity in Human Cholangiocarcinoma: An Overview of Current Perspectives

Pastore

Lori

Gentilini

et al. 2020

Cells

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Cholangiocarcinoma (CCA) is a deadly tumor without an effective therapy. Unique metabolic and bioenergetics features are important hallmarks of tumor cells. Metabolic plasticity allows cancer cells to survive in poor nutrient environments and maximize cell growth by sustaining survival, proliferation, and metastasis. In recent years, an increasing number of studies have shown that specific signaling networks contribute to malignant tumor onset by reprogramming metabolic traits. Several evidences demonstrate that numerous metabolic mediators represent key-players of CCA progression by regulating many signaling pathways. Besides the well-known Warburg effect, several other different pathways involving carbohydrates, proteins, lipids, and nucleic acids metabolism are altered in CCA. The goal of this review is to highlight the main metabolic processes involved in the cholangio-carcinogeneis that might be considered as potential novel druggable candidates for this disease.

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Cholangiocarcinoma: classification, diagnosis, staging, imaging features, and management

Cited by 95 publications

References 60 publications

Anatomical, histomorphological and molecular classification of cholangiocarcinoma

Anatomical, histomorphological and molecular classification of cholangiocarcinoma

Imaging Diagnosis of Intrahepatic and Perihilar Cholangiocarcinoma: Recent Advances and Challenges

Multifaceted Aspects of Metabolic Plasticity in Human Cholangiocarcinoma: An Overview of Current Perspectives

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