Congenital dilatation of the intrahepatic bile ducts with cholangiocarcinoma

Gallagher, Peggy A.; Millis, Rosemary R.; Mitchinson, M. J.

doi:10.1136/jcp.25.9.804

Cited by 108 publications

(30 citation statements)

References 16 publications

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“…ICC is also known to occur in thorotrast deposition, liver flukes (Clonorchis sinesis and Opisthorchis viverrini) infestations, and congenital biliary anomalies. 1,14,[25][26][27][28][29] In liver fluke infestation, the bile ducts first show desquamation of the biliary epithelium with subsequent development of adenomatous hyperplasia and periductal fibrosis in addition to inflammation and goblet cell metaplasia. 30 Neoplastic transformation from adenomatous change in bile ducts to ICC through dysplastic changes is also demonstrable in Opisthorchiasis.…”

Section: Discussionmentioning

confidence: 99%

Intraductal papillary neoplasia of the liver associated with hepatolithiasis

2001

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Intrahepatic cholangiocarcinoma (ICC) is a primary malignancy of the liver second in prevalence only to hepatocellular carcinoma. 1 In East-Asian countries where hepatolithiasis is not uncommon, ICC is known to develop in patients with hepatolithiasis: the incidence of ICC in hepatolithiasis in Taiwan and Japan is approximately 5%. [2][3][4] ICCs, at least those arising in hepatolithiasis, are known to show multistep progression, undergoing a biliary dysplasia-carcinoma sequence. 1 With recent advances in imaging technology, ICC can now be detected relatively early and is surgically resectable. Surgically resectable ICCs are divided into 3 gross types (massforming [MF], periductal-infiltrating [PI], and intraductalgrowth [IG] types). 5 The IG type is the least common and shows a predominant intraductal growth with no or mild extension beyond the bile duct walls. Recently, ICC of the IG type has received attention in Asian countries. Suh et al. 6 reported 16 cases among 122 surgically resected ICCs (14.3%) in Korea, and that such cases had a better prognosis after complete surgical resection. In Japan, Ohashi et al. 7 reported that 6 of 72 surgically resectable cases of ICC were of the IG type. Previously used terms such as mucin-producing ICC, intraductal mucosal-spreading mucin-producing peripheral cholangiocarcinoma, intraductal growth type of peripheral cholangiocarcinoma, and intraductal variant of peripheral cholangiocarcinoma, 8-10 describe neoplasms similar to or identical to the IG type. Although there have been a number of clinical studies on this type of ICC, the histogenesis and progression of this type remains speculative.Biliary neoplasms arising in hepatolithiasis present occasionally with intraductal papillary carcinoma with and without variable periductal invasion, and intraductal papillary proliferation with variable dysplasia is also encountered in hepatolithiasis. 6,11 To date, the histogenesis, histopathology, and early and advanced lesions of this tumor have not been explored in detail.In this study, we examined a total of 62 cases of hepatolithiasis with intraductal papillary growth of dysplastic and carcinomatous biliary epithelia of the intrahepatic biliary, including mucin-producing ICC in Taiwan, and described the histopathologic features with respect to the background biliary pathology and also in comparison with hepatolithiasis cases in Japan. MATERIALS AND METHODS Classification of the Intrahepatic Biliary TreeThe intrahepatic biliary tree is distal to the right and left hepatic duct and is further classified into intrahepatic large bile ducts, septal bile ducts, interlobular bile ducts, and bile ductules. 12 Intrahepatic large bile ducts are recognizable grossly and are continuous with the intrahepatic peribiliary glands. Septal bile ducts are microscopically identifiable and are composed of columnar epithelial cells and thick fibrous bile duct walls (internal diameter Ͼ100 m). Interlobular bile ducts are composed of low-columnar or cuboidal epithelial cells, but lack periductal fi...

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Section: Discussionmentioning

confidence: 99%

Intraductal papillary neoplasia of the liver associated with hepatolithiasis

2001

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“…A MEDLINE search of all pertinent articles yielded reports of 12 patients in whom bile duct cancer developed after the primary resection of congenital biliary dilation (Table 1). [1][2][3][4][5][6][7][8][9] The 13 patients, including our own, consisted of 3 men and 10 women, and they ranged in age from 16 to 61 years. The mean period between the primary operation and the development of cancer was 8.2 years, ranging from 1.8 to 19.5.…”

Section: Discussionmentioning

confidence: 99%

“…However, some patients have been reported to develop biliary cancer long after a "separation-operation". [1][2][3][4][5][6][7][8][9] Most of the development in these patients occurs in the dilated bile duct (for instance, in the remnant choledochal cyst) in the hepatic duct at the anastomotic site, and in the intrahepatic bile duct, in Todani's type IV-A classification of congenital biliary dilation. 10 The development of intrahepatic cholangiocarcinoma after the "separation-operation" has not been reported in patients without dilation of the intrahepatic bile duct (such as those with Todani's type I congential biliary dilation).…”

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confidence: 99%

Intrahepatic cholangiocarcinoma arising 10 years after the excision of congenital extrahepatic biliary dilation

Goto

Yasuda

Uematsu

et al. 2001

Journal of Gastroenterology

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A 52-year-old woman was found to have a liver tumor during treatment for a liver abscess. The tumor was diagnosed as intrahepatic cholangiocarcinoma by closer examinations, including a percutaneous needle biopsy. Ten years previously, she had undergone excision of a choledochal cyst, with reconstruction by Roux-en-Y hepaticojejunostomy, as treatment for Todani's type Ia congenital biliary dilation, which had been confined only to the extrahepatic bile duct. The significant association between congenital biliary dilation and hepatobiliary malignancies is well known. Some patients have been reported to develop biliary cancer long after the excision of the entire extrahepatic bile duct and hepaticoenterostomy. However, in these patients, the development mostly took place in the remnant choledochal cyst, the anastomotic site, or in the dilated intrahepatic bile duct of Todani's type IV-A congenital biliary dilation. The development of intrahepatic cholangiocarcinoma after operation has not been reported previously in a patient with Todani's type I congenital biliary dilation. This case suggests that the entire biliary tree may have a high risk of field cancerization, even in extrahepatic congenital biliary dilation.

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“…Only a few reports exist in the English literature [10][11][12][13]. No case has been reported in which all diagnostic procedures failed to delineate a communication between the cystic lesion containing carcinoma and the biliary tree.…”

Section: Discussionmentioning

confidence: 97%