Mucosal dysplasia of the liver and the intraductal variant of peripheral cholangiocarcinoma in hepatholithiasis

Ohta, Tetsuo; Nagakawa, Takukazu; Ueda, Nobuhiko; Nakamura, Takashi; Akiyama, Takayoshi; Ueno, Koichi; Miyazaki, Itsuo

doi:10.1002/1097-0142(19911115)68:10<2217::aid-cncr2820681021>3.0.co;2-v

Cited by 66 publications

(33 citation statements)

References 11 publications

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“…Chronic biliary infection or stasis, regardless of the presence of hepatolithiasis, has been considered to be a contributing factor in the development of mucosal adenomatous epithelial hyperplasia and bile duct carcinoma. 19,20 In this study, adenomatous hyperplasia was found in all pathological specimens.…”

Section: Discussionmentioning

confidence: 53%

Clinicopathologic features of the intraductal growth type of peripheral cholangiocarcinoma

et al. 2000

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The clinicopathologic features of the intraductal growth (IG) type of peripheral cholangiocarcinoma (PCC) were examined retrospectively. Out of 112 patients who underwent surgery for PCC at Seoul National University Hospital, Seoul, Korea, between January 1980 and December 1997, 16 were classified as having the IG type. Thirteen were men and 3 were women. Their ages ranged from 38 to 73 years with a mean age of 55.9 years. Abdominal pain was the most common symptom and jaundice was found in 18.8%. Five patients had associated clonorchiasis and 6 patients experienced hepatolithiasis. Tumor sizes ranged from 0.5 cm to 14.0 cm with a mean of 4.3 cm. The tumor was located in the right lobe in 7 cases and the left lobe in 9 cases. Thirteen patients underwent major hepatic resection, and 3 underwent minor resection, involving a subsegmentectomy. Mucin was found in the bile in 4 cases. Pathology showed papillary adenocarcinoma with a background of adenomatous hyperplasia, and the absence of lymph node metastasis in all cases. The tumors were confined to the mucosa in 5 cases. Out of the 16 hepatic resections, 1 was palliative due to a positive margin. In 2 of the patients who underwent minor resections, recurrences developed, and 1 of these died 56 months after resection. Out of the 16 patients, 15 remain alive, ranging from 1 to 13 years, postoperatively. In conclusion, the IG type of PCC should be distinguished from other types of PCC because a favorable prognosis can be expected after complete surgical resection. (HEPATOLOGY 2000;31:12-17.)Intrahepatic or peripheral cholangiocarcinoma (PCC), a primary adenocarcinoma of the liver originating from the intrahepatic bile ducts (IHD), is the second most common primary hepatic malignancy, next to hepatocellular carcinoma. 1 Because the lesion is advanced by the time of diagnosis, 2 the possibility of surgical resection is limited and the prognosis is generally poor. [3][4][5][6][7][8][9] In 1992, Yamamoto et al. 10 classified PCC into 2 types, mass-forming (MF) and periductal-infiltrating (PI), and showed their different clinical behaviors. The MF type creates an apparent lesion in the liver, with frequent remnant hepatic recurrence after resection. The PI type causes a stricture or an obstruction of the IHD without forming a definite mass in the liver. It spreads along the Glisson' s capsule and metastasizes to the hilar lymph nodes. Later, another type, intraductal growth (IG), was added. 11 This type of tumor shows a papillary growth into the lumen of the bile duct. 12 There have been a few scattered reports about the clinical and pathological features of the IG type of PCC. 13,14 Here, we describe the clinical and pathological features of the IG type of PCC in 16 patients who underwent surgical resection at

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Section: Discussionmentioning

confidence: 53%

Clinicopathologic features of the intraductal growth type of peripheral cholangiocarcinoma

et al. 2000

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“…Chronic biliary infection or stasis, regardless of the under- (56,84) have hypothesized that the lining epithelium of the bile duct, when persistently exposed to biochemically altered bile, may undergo a carcinomatous transformation through the stages of mucosal adenomatous hyperplasia and dysplasia. Recurrent pyogenic cholangitis (also called Oriental cholangiohepatitis or intrahepatic pigmented-stone disease), which is also endemic in the Far East, is associated with cholangiocarcinoma in 5 to 10% of cases (9,81).…”

Section: Etiologymentioning

confidence: 99%

“…In 1956, Hou speculated that some carcinogenic substance might act synergistically with C. sinensis to induce cholangio- (84) hypothesized that the lining epithelium of the bile duct, when persistently exposed to chemically altered bile, may undergo a carcinomatous transformation through a stage of mucosal dysplasia. While these propositions seem plausible, it now appears that exogenous environmental carcinogens, which are ubiquitous in nature, are more important.…”

Section: Exogenous and Endogenous Chemical Carcinogensmentioning

confidence: 99%

Clonorchiasis and Cholangiocarcinoma: Etiologic Relationship and Imaging Diagnosis

et al. 2004

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Despite a gradual decrease in prevalence, clonorchiasis is still prevalent in East Asia. A large and compelling body of evidence links clonorchiasis and cholangiocarcinoma, although the mechanisms involved are not completely understood. Clonorchiasis induces biliary epithelial hyperplasia and metaplasia, and this could facilitate at least one stage of the carcinogenesis, which is promoting effect. In areas of endemic infection, more clonorchiasis cases are now diagnosed incidentally during radiological examinations such as cholangiography, ultrasonography, and computed tomography. Radiological findings are regarded as pathognomonic for clonorchiasis since they reflect the unique pathological changes of this disorder. These radiological examinations currently play important roles in the diagnosis, staging, and decision-making process involved in the treatment of cholangiocarcinoma. The morphological features and radiological findings of clonorchiasis-associated cholangiocarcinoma are essentially combinations of the findings for the two diseases. The morphological features of clonorchiasis- associated cholangiocarcinoma, observed in radiological examinations, do not differ from those of the usual cholangiocarcinoma. In patients diagnosed with or suspected to have clonorchiasis, radiological findings should be carefully scrutinized for occult cholangiocarcinoma

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“…6,11 To date, the histogenesis, histopathology, and early and advanced lesions of this tumor have not been explored in detail.…”

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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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Mucosal dysplasia of the liver and the intraductal variant of peripheral cholangiocarcinoma in hepatholithiasis

Cited by 66 publications

References 11 publications

Clinicopathologic features of the intraductal growth type of peripheral cholangiocarcinoma

Clinicopathologic features of the intraductal growth type of peripheral cholangiocarcinoma

Clonorchiasis and Cholangiocarcinoma: Etiologic Relationship and Imaging Diagnosis

Intraductal papillary neoplasia of the liver associated with hepatolithiasis

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