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What are the precursor and early lesions of peripheral intrahepatic cholangiocarcinoma?

Nakanuma Y, Tsutsui A, Ren XS, Harada K, Sato Y, Sasaki M - Int J Hepatol (2014)

Bottom Line: In the background liver of peripheral ICC, BDA and BAF were not found, but there were not infrequently foci of BDA-like lesions and atypical bile duct lesions involving small bile ducts (32.4% and 10.8%, resp.).VMCs were equally found in peripheral CCs and also control CCs.In conclusion, BDA, BAF, and VMCs are a possible precursor lesion of a minority of peripheral CCs, and BDA-like lesions and atypical bile duct lesions involving small bile ducts may also be related to the development of peripheral ICC.

View Article: PubMed Central - PubMed

Affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan ; Department of Pathology, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.

ABSTRACT
Cholangiocarcinoma (CC) is divided into distal, perihilar, and intrahepatic CCs (ICCS), and are further subdivided into large bile duct ICC and peripheral ICC. In distal and perihilar CC and large duct ICC, biliary intraepithelial neoplasm (BilIN) and intraductal papillary neoplasm (IPN) have been proposed as precursor lesions. Peripheral ICC, bile duct adenoma (BDA), biliary adenofibroma (BAF), and von Meyenburg complexes (VMCs) are reportedly followed by development of ICCs. Herein, we surveyed these candidate precursor lesions in the background liver of 37 cases of peripheral ICC and controls (perihilar CC, 34 cases; hepatocellular carcinoma, 34 cases and combined hepatocellular cholangiocarcinoma, 25 cases). In the background liver of peripheral ICC, BDA and BAF were not found, but there were not infrequently foci of BDA-like lesions and atypical bile duct lesions involving small bile ducts (32.4% and 10.8%, resp.). VMCs were equally found in peripheral CCs and also control CCs. In conclusion, BDA, BAF, and VMCs are a possible precursor lesion of a minority of peripheral CCs, and BDA-like lesions and atypical bile duct lesions involving small bile ducts may also be related to the development of peripheral ICC. Further pathologic studies on these lesions are warranted for analysis of development of peripheral ICCs.

No MeSH data available.


Related in: MedlinePlus

Bile duct adenoma-like lesion. (a) Small nodule composed of abundant interlobular bile ducts and fibrous stroma is found in the deep part of the liver. HE. (b) Small nodule of dense small interlobular bile ducts is found in the deep part of the liver. HE.
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fig4: Bile duct adenoma-like lesion. (a) Small nodule composed of abundant interlobular bile ducts and fibrous stroma is found in the deep part of the liver. HE. (b) Small nodule of dense small interlobular bile ducts is found in the deep part of the liver. HE.

Mentions: The above-mentioned, three biliary lesions were surveyed in our cases (Table 1). In these cases, chronic biliary diseases such as hepatolithiasis and primary sclerosing cholangitis were not found. As shown in Table 2, biliary adenofibroma was not found in the background liver or at the rim of peripheral CCs. As for typical, subcapsular BDA, it was found in one of 25 HCC cases and one of 18 cHC-CC cases, but not in peripheral ICC. Instead, bile duct adenoma-like lesions (Figures 4(a) and 4(b)) which were a little different from BDA, itself, were found in the background liver of one-third of peripheral ICCs (32.4%). These lesions were composed of dense and localized cluster of matured interlobular bile ducts, and their overall size was rather small ranging from 1 mm to 3 mm. They were alone or several in a given liver specimen and were found in fibrous septa or enlarged portal tract of the deep hepatic parenchyma. While these lesions were also found in 33.3% of cHC-CC cases, such lesions were infrequent in perihilar CC and HCC (11.8% and 12%, resp.), suggesting that this type of lesion could be related to peripheral ICC. As for VMCs, they were found focally and multiple in 24.3% of peripheral ICC cases and also other three controls (17.6% of hilar CC, 28% of HCC, and 33.3% of cHC-CC).


What are the precursor and early lesions of peripheral intrahepatic cholangiocarcinoma?

Nakanuma Y, Tsutsui A, Ren XS, Harada K, Sato Y, Sasaki M - Int J Hepatol (2014)

Bile duct adenoma-like lesion. (a) Small nodule composed of abundant interlobular bile ducts and fibrous stroma is found in the deep part of the liver. HE. (b) Small nodule of dense small interlobular bile ducts is found in the deep part of the liver. HE.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4016917&req=5

fig4: Bile duct adenoma-like lesion. (a) Small nodule composed of abundant interlobular bile ducts and fibrous stroma is found in the deep part of the liver. HE. (b) Small nodule of dense small interlobular bile ducts is found in the deep part of the liver. HE.
Mentions: The above-mentioned, three biliary lesions were surveyed in our cases (Table 1). In these cases, chronic biliary diseases such as hepatolithiasis and primary sclerosing cholangitis were not found. As shown in Table 2, biliary adenofibroma was not found in the background liver or at the rim of peripheral CCs. As for typical, subcapsular BDA, it was found in one of 25 HCC cases and one of 18 cHC-CC cases, but not in peripheral ICC. Instead, bile duct adenoma-like lesions (Figures 4(a) and 4(b)) which were a little different from BDA, itself, were found in the background liver of one-third of peripheral ICCs (32.4%). These lesions were composed of dense and localized cluster of matured interlobular bile ducts, and their overall size was rather small ranging from 1 mm to 3 mm. They were alone or several in a given liver specimen and were found in fibrous septa or enlarged portal tract of the deep hepatic parenchyma. While these lesions were also found in 33.3% of cHC-CC cases, such lesions were infrequent in perihilar CC and HCC (11.8% and 12%, resp.), suggesting that this type of lesion could be related to peripheral ICC. As for VMCs, they were found focally and multiple in 24.3% of peripheral ICC cases and also other three controls (17.6% of hilar CC, 28% of HCC, and 33.3% of cHC-CC).

Bottom Line: In the background liver of peripheral ICC, BDA and BAF were not found, but there were not infrequently foci of BDA-like lesions and atypical bile duct lesions involving small bile ducts (32.4% and 10.8%, resp.).VMCs were equally found in peripheral CCs and also control CCs.In conclusion, BDA, BAF, and VMCs are a possible precursor lesion of a minority of peripheral CCs, and BDA-like lesions and atypical bile duct lesions involving small bile ducts may also be related to the development of peripheral ICC.

View Article: PubMed Central - PubMed

Affiliation: Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan ; Department of Pathology, Shizuoka Cancer Center, Shizuoka 411-8777, Japan.

ABSTRACT
Cholangiocarcinoma (CC) is divided into distal, perihilar, and intrahepatic CCs (ICCS), and are further subdivided into large bile duct ICC and peripheral ICC. In distal and perihilar CC and large duct ICC, biliary intraepithelial neoplasm (BilIN) and intraductal papillary neoplasm (IPN) have been proposed as precursor lesions. Peripheral ICC, bile duct adenoma (BDA), biliary adenofibroma (BAF), and von Meyenburg complexes (VMCs) are reportedly followed by development of ICCs. Herein, we surveyed these candidate precursor lesions in the background liver of 37 cases of peripheral ICC and controls (perihilar CC, 34 cases; hepatocellular carcinoma, 34 cases and combined hepatocellular cholangiocarcinoma, 25 cases). In the background liver of peripheral ICC, BDA and BAF were not found, but there were not infrequently foci of BDA-like lesions and atypical bile duct lesions involving small bile ducts (32.4% and 10.8%, resp.). VMCs were equally found in peripheral CCs and also control CCs. In conclusion, BDA, BAF, and VMCs are a possible precursor lesion of a minority of peripheral CCs, and BDA-like lesions and atypical bile duct lesions involving small bile ducts may also be related to the development of peripheral ICC. Further pathologic studies on these lesions are warranted for analysis of development of peripheral ICCs.

No MeSH data available.


Related in: MedlinePlus