Histological confirmation of periductal fibrosis from ultrasound diagnosis in cholangiocarcinoma patients

Abstract

Cholangiocarcinoma (CCA) has no specific clinical signs and symptoms and non‐specific bio‐ and tumor‐markers in the early disease stage. Usually patients present to tertiary care with advanced disease stage. In order to detect early cases of CCA that may present as a mass, dilatation of intrahepatic duct or combination, ultrasonography is accepted as a powerful imaging tool. A smaller mass or bile duct segmental dilatation requires further imaging for characterization, including computerized tomography (CT) or magnetic resonance imaging (MRI). We examined whether liver echo pattern was correlated with high risk for CCA in an endemic area of Opisthorchis viverrini (Ov). Ov infestation caused chronic inflammation of the biliary tree by periductal fibrosis (PDF), which may subsequently lead to CCA development. In our study, a World Health Organization classification of pattern of increased periportal echo (IPE) for schistosomiasis was applied. Two CCA patients gave consent for operation. Histopathological diagnosis showed both had cholangiocarcinoma with periductal fibrosis of the non‐tumorous area of the liver. Ultrasonography was used to compare the non‐tumorous area with parenchymal echo pattern and was shown to have an early CCA detection role and a surveillance role in an endemic area of Ov by detection of PDF.

Differential Protein Expression Marks the Transition From Infection With Opisthorchis viverrini to Cholangiocarcinoma

“…Hamsters that are infected with Ov and fed a diet supplemented with NDMA progress to CCA whereas those that are infected with Ov but do not receive NDMA do not progress to CCA during a six month animal trial (11). In this animal model of CCA, the biliary epithelium of the hamster is markedly inflamed and displays fibrosis advancing along its length after 12 weeks of infection (12), with this is fibrotic deposition routinely present at the biliary epithelium that leads to CCA (8,13). …”

Preliminary genetic evidence of two different populations of Opisthorchis viverrini in Lao PDR

“…Humans are exposed by eating raw or partially cooked fish infected with viable metacercariae of O. viverrini (Grundy-Warr et al 2012; Sithithaworn and Haswell-Elkins 2003). Early human infection is commonly asymptomatic but chronic infection can lead to hepatobiliary disease and subsequent cholangiocarcinoma (CCA) (Chamadol et al 2014; Sithithaworn et al 2014). CCA has a very poor prognosis with death typically occurring within a few months of diagnosis (Sripa et al 2007).…”

A Web-based Integrated Medical Information System for Cholangiocarcinoma Screening and Periductal Fibrosis Ultrasound Image Processing

“…The periductal fibrosis ultrasound images can be applied for the cholangiocarcinoma screening system which increased patient survivability [5][6][7][8]. However, the ultrasound images are lack of contrast and a lot of speckle noise.…”