Histological diversity in cholangiocellular carcinoma reflects the different cholangiocyte phenotypes

Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA)

“…Conversely, iCCAs are highly heterogeneous tumours and several classifi cations have been proposed 11,13,17,18 . However, despite differences in nomenclature, iCCAs show two main histological subtypes, reflecting their anatomical origin along the intrahepatic biliary tree: bile ductular type (mixed) (FIG.…”

“…3A), arising from small intrahepatic bile ducts, and bile duct type (mucinous) (FIG. 3B), arising from large intrahepatic bile ducts 11,13,17,18 . Interestingly, this histological sub classification corresponds to different clinico pathological features.…”

“…Interestingly, this histological sub classification corresponds to different clinico pathological features. The bile ductular type (mixed) iCCAs display an almost exclusively massforming growth pattern 11,13,17,18 , are frequently associated with chronic liver diseases (viral hepatitis or cirrhosis) 19 and are not preceded by pre-neoplastic lesions such as biliary intraepithelial neoplasm or intraductal papillary neoplasm 11,13,17,18 . Notably, bile ductular type (mixed) iCCAs share clinicopathological similarities with cytokeratin (CK) 19-positive hepato cellular carcinoma (HCC) 17,20 .…”

“…The bile ductular type (mixed) iCCAs display an almost exclusively massforming growth pattern 11,13,17,18 , are frequently associated with chronic liver diseases (viral hepatitis or cirrhosis) 19 and are not preceded by pre-neoplastic lesions such as biliary intraepithelial neoplasm or intraductal papillary neoplasm 11,13,17,18 . Notably, bile ductular type (mixed) iCCAs share clinicopathological similarities with cytokeratin (CK) 19-positive hepato cellular carcinoma (HCC) 17,20 . On the other hand, bile duct type (mucinous) iCCAs might appear grossly as mass-forming, periductal infiltrating or intraductal growing types; they are more frequently associ ated with primary sclerosing cholangitis (PSC) than bile ductular type (mixed) iCCAs, and can be preceded by pre neoplastic lesions such as biliary intra epithelial neoplasm or intraductal papillary neoplasm 11,13,17,18 .…”

“…Notably, bile ductular type (mixed) iCCAs share clinicopathological similarities with cytokeratin (CK) 19-positive hepato cellular carcinoma (HCC) 17,20 . On the other hand, bile duct type (mucinous) iCCAs might appear grossly as mass-forming, periductal infiltrating or intraductal growing types; they are more frequently associ ated with primary sclerosing cholangitis (PSC) than bile ductular type (mixed) iCCAs, and can be preceded by pre neoplastic lesions such as biliary intra epithelial neoplasm or intraductal papillary neoplasm 11,13,17,18 . Interestingly, the bile duct type (mucinous) iCCAs share phenotypic traits with pCCA and pancreatic cancers 17 .…”