Pathological aspects of cholangiocarcinoma

Abstract

Cholangiocarcinoma (CC) arises from the biliary epithelium and in most cases represents adenocarcinoma. Pathomorphological evaluation is of decisive impact for the prognosis and management of CC. Morphological subtyping (histotype; hilar vs peripheral type), TNM classification, lymphatic spread, and resection margin status are of prognostic relevance. Distinction from hepatic metastases may be aided by immunohistology and clinico-pathological correlation. There is convincing evidence of the development of CC via premalignant lesions, especially biliary intraepithelial neoplasia, although further knowledge about the biology and diagnostic definition of these lesions has to be accumulated. Currently, there are no established molecular markers of prognosis or therapeutic target structures to be evaluated at the tissue level. Future progress is needed and expected in novel differential diagnostic and predictive markers, in uniform definition of resection margin status and further understanding of molecular and morphological changes in the development of CC.

Epidemiology of cholangiocarcinoma: An update focusing on risk factors

“…Although progress on cholangiocarcinoma prevention and treatment has been steady, more studies related to classification and risk factors will be helpful to develop an advanced strategy to cure and prevent cholangiocarcinoma. (Cancer Sci 2010; 101: 579-585) C holangiocarcinomas (CCAs) -primarily cancers of the epithelial cells (mostly adenocarcinoma) in the bile ducts arising anywhere along the intrahepatic or extrahepatic biliary tree (1,2) -are relatively rare, but high incidence rates have been reported in Eastern Asia, especially in Thailand. (3) CCAs are highly fatal tumours, as they are clinically silent in the majority of cases.…”

Novel Potential Biomarkers for Opisthorchis viverrini Infection and Associated Cholangiocarcinoma

“…CCA is a tumor arising from epithelial cells of the intrahepatic or extrahepatic bile ducts (12). Endemic areas for liver fluke infection, such as Thailand and China (13), are also the regions with the highest worldwide incidence of both intrahepatic and extrahepatic CCA.…”

Expression of MUC1, MUC2, MUC5AC and MUC6 in cholangiocarcinoma: Prognostic impact

“…Since all of these organs may give rise to carcinomas with similar morphological features, identification of the exact origin relies on precise macroscopy but may be impossible in a larger tumor (33). Many studies have made efforts to distinguish CC from pancreas and gallbladder adenocarcinoma.…”