Primary sclerosing cholangitis and cholangiocarcinoma as a diagnostic and therapeutic dilemma

Leeuwen, D. J. Van; Reeders, Jacques W. A. J.

doi:10.1093/annonc/10.suppl_4.s89

Cited by 26 publications

(10 citation statements)

References 47 publications

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“…3 Patients with PSC have an increased predisposition to develop malignancy, [6][7][8] with an increased risk of cholangiocarcinoma and hepatocellular carcinoma in > 15% of patients. [9][10][11] Patients with ulcerative colitis have a high incidence of colon cancer. The increased predisposition toward malignancy in both disorders is probably due to long-standing inflammation.…”

Section: Objective: To Assess the Role Of Brush Cytology In The Routimentioning

confidence: 99%

Role of Biliary Brush Cytology in Primary Sclerosing Cholangitis

et al. 2004

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Section: Objective: To Assess the Role Of Brush Cytology In The Routimentioning

confidence: 99%

Role of Biliary Brush Cytology in Primary Sclerosing Cholangitis

et al. 2004

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“…However, KRAS2 mutations have been reported to be present in benign pancreatobiliary conditions too, such as chronic pancreatitis and primary biliary cirrhosis. 5,29,30 The mutant cells in these lesions could be shed into the fluid, and mutant DNA could be detected in pancreatic juice or bile. This is supported by our previous and current studies.…”

Section: Discussionmentioning

confidence: 99%

“…Although recent progress has been made in various imaging modalities such as endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography, and magnetic resonance imaging, diagnosis of biliary tract carcinoma at an early stage is still difficult in many cases. 4,5 In addition, it is technically challenging to perform endoscopic biopsy because of the presence of biliary strictures associated with small lesions. Although biliary tract carcinoma is derived from the bile duct epithelium, endobiliary brush cytology typically yields a low sensitivity of detection for malignancy.…”

mentioning

confidence: 99%

Ultrasensitive Detection of KRAS2 Mutations in Bile and Serum from Patients with Biliary Tract Carcinoma Using LigAmp Technology

Shi

Chandrasekaran

Thuluvath

et al. 2009

The Journal of Molecular Diagnostics

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Patients with biliary tract carcinoma have a poor prognosis. Early detection efforts are urgently needed to ameliorate the dismal prognosis for these patients. Mutations of the KRAS2 gene are one of the most common genetic aberrations in this cancer. In this study , we used LigAmp , an ultrasensitive technology for detecting point mutations , to analyze KRAS2 mutations in patients with a variety of neoplastic and non-neoplastic pancreatobiliary diseases. DNA was isolated from 64 samples , including 44 bile samples and 20 serum samples. Oligonucleotides specific for KRAS2 G35A (GAT , G12D) , G35T (GTT , G12V), and G34A (AGT , G12S) mutations were used. KRAS2 mutations were detected in 14 of 16 (87.5%) neoplastic bile samples and in 9 of 28 (32.1%) non-neoplastic bile samples. However , the mutation levels were significantly lower in the non-neoplastic bile (median ‫؍‬ 0.4%) compared with those in the neoplastic bile (median ‫؍‬ 5.1%). KRAS2 mutations were also detected in 9 of 11 (81.8%) serum samples from patients with biliary tract carcinoma , which was further confirmed by cloning BstN1-refractory PCR products and DNA sequencing. However , KRAS2 mutations were not present in the sera from eight patients with benign pancreatobiliary diseases. These data demonstrate that KRAS2 mutations are detectable in both bile and serum using LigAmp. This technology has the potential for early biliary tract carcinoma detection and possibly for residual disease monitoring post-therapy. (J Mol

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“…Follicular cholangitis is difficult to diagnose, as it is particularly challenging to distinguish from primary sclerosing cholangitis, immunoglobulin G4 (IgG4)-related sclerosing cholangitis and hilar cholangiocarcinoma (1)(2)(3)(4). Follicular cholangitis is relatively rare; it was first reported by Aoki et al (5) in 2003, and only a few cases have been reported to date (5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Follicular cholangitis associated with focal biliary stricture treated with left hepatectomy after 8 years of follow-up: A rare case report

Saito

Fukuda

Amano

et al. 2015

Molecular and Clinical Oncology

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Abstract. Follicular cholangitis may lead to severe focal biliary stricture, which is difficult to distinguish from cholangiocarcinoma. This is the report of a rare case of follicular cholangitis associated with an intrahepatic focal biliary stricture in a 69-year-old woman. The patient visited our hospital for upper abdominal pain in 2006. Computed tomography revealed common bile duct stones and focal stricture of the left intrahepatic duct. Endoscopic retrograde cholangiopancreatography revealed a severe B3 stricture and dilation of the peripheral biliary tract. Repeated cytology revealed no malignancy. The patient was followed up for 8 years and repeated attacks of cholangitis severely compromised her quality of life. A left hepatectomy was performed, and the pathological findings were consistent with follicular cholangitis. It is generally difficult to make a definitive diagnosis after identifying a biliary stricture, and the stricture is often treated with surgical resection. The clinical presentation and radiological findings of follicular cholangitis are similar to those of cholangiocarcinoma; therefore, if a conservative approach is selected, frequent follow-up is recommended. The present case suggests that follicular cholangitis should be considered in the differential diagnosis of biliary stricture. IntroductionFollicular cholangitis is difficult to diagnose, as it is particularly challenging to distinguish from primary sclerosing cholangitis, immunoglobulin G4 (IgG4)-related sclerosing cholangitis and hilar cholangiocarcinoma (1-4). Follicular cholangitis is relatively rare; it was first reported by Aoki et al (5) in 2003, and only a few cases have been reported to date (5-9). Imaging findings representative of this disease include biliary stricture associated with dilatation of the peripheral bile duct and lymph node enlargement. Certain patients have undergone surgical treatment for preoperative diagnosis of cholangiocarcinoma, which was finally diagnosed as a benign condition (10).It was previously demonstrated that the majority of the cases are diagnosed as cholangiocarcinoma due to the severe biliary stricture and the presence of symptoms, which commonly include abdominal pain and jaundice. Follicular cholangitis has recently been reported to be among several diseases that cause biliary stricture. The reported pathological findings of this disease are fibrotic thickening of the wall of the hilar bile duct; prominent hyperplastic lymph follicles with germinal centers in the subserosal layer, without tumorous growth, which were considered to be reactive hyperplastic follicles, with localization of the lesions in the proximal extrahepatic bile duct and hepatic hilum, and with almost intact peripheral intrahepatic bile ducts (8).We herein report the case of a 69-year-old woman with follicular cholangitis associated with a focal biliary stricture, who underwent left hepatectomy after 8 years of follow-up. Case reportA 69-year-old woman was referred to our hospital due to repeated hepatolithiasis and c...

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Primary sclerosing cholangitis and cholangiocarcinoma as a diagnostic and therapeutic dilemma

Cited by 26 publications

References 47 publications

Role of Biliary Brush Cytology in Primary Sclerosing Cholangitis

Role of Biliary Brush Cytology in Primary Sclerosing Cholangitis

Ultrasensitive Detection of KRAS2 Mutations in Bile and Serum from Patients with Biliary Tract Carcinoma Using LigAmp Technology

Follicular cholangitis associated with focal biliary stricture treated with left hepatectomy after 8 years of follow-up: A rare case report

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