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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

Schema of precursor lesions of peripheral intrahepatic cholangiocarcinoma (peripheral-ICC). Some of so-called benign lesions such as bile duct adenoma, von Meyenburg complex, and biliary adenofibroma are occasionally followed by the development of peripheral-ICC, and some of low grade cholangiocarcinoma (cholangiolocellular carcinoma and cholangiocarcinoma with ductal plate malformation (DPM)-like features) are also followed by ordinary peripheral-ICC. In addition, bile duct adenoma-like lesion and atypical small bile duct lesions described here could be also related to the development of peripheral ICC. Unidentified factors or lesions and may also be involved in the development of peripheral ICC.
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fig8: Schema of precursor lesions of peripheral intrahepatic cholangiocarcinoma (peripheral-ICC). Some of so-called benign lesions such as bile duct adenoma, von Meyenburg complex, and biliary adenofibroma are occasionally followed by the development of peripheral-ICC, and some of low grade cholangiocarcinoma (cholangiolocellular carcinoma and cholangiocarcinoma with ductal plate malformation (DPM)-like features) are also followed by ordinary peripheral-ICC. In addition, bile duct adenoma-like lesion and atypical small bile duct lesions described here could be also related to the development of peripheral ICC. Unidentified factors or lesions and may also be involved in the development of peripheral ICC.

Mentions: In conclusion, several precursor or early neoplastic lesions of peripheral ICC reported in the literature were reviewed in the present study (Figure 8). Bile duct adenoma, biliary adenofibroma, and VMCs are reportedly associated with histologic features of malignancy or borderline lesions, and these lesions may be followed by carcinoma in a minority of peripheral ICC. Survey of unusual or atypical biliary lesions in peripheral ICC showed that bile duct adenoma-like lesions and atypical biliary lesions of small bile ducts were not infrequent in the background liver, possibly related to the development of peripheral ICC. In addition, several borderline or low grade biliary malignancies such as CLC or ICC with DPM-like structures frequently contain the foci of ordinary peripheral ICC, suggesting their transition to peripheral ICC and multistep cholangiocarcinogenesis. In hilar and extrahepatic CCs, the precursor lesions such as BilIN and IPN of bile duct are now being recognized and have been studied actively. More extensive surveys on precursor or premalignant lesions as well as more sophisticated studies based on pathologically confirmed precursor lesions in peripheral ICC as well as on those in hilar and extrahepatic CCs may lead to the earlier detection of and a better prognosis after surgical resection of peripheral ICC and hilar and extrahepatic CCs.


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)

Schema of precursor lesions of peripheral intrahepatic cholangiocarcinoma (peripheral-ICC). Some of so-called benign lesions such as bile duct adenoma, von Meyenburg complex, and biliary adenofibroma are occasionally followed by the development of peripheral-ICC, and some of low grade cholangiocarcinoma (cholangiolocellular carcinoma and cholangiocarcinoma with ductal plate malformation (DPM)-like features) are also followed by ordinary peripheral-ICC. In addition, bile duct adenoma-like lesion and atypical small bile duct lesions described here could be also related to the development of peripheral ICC. Unidentified factors or lesions and may also be involved in the development of peripheral ICC.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig8: Schema of precursor lesions of peripheral intrahepatic cholangiocarcinoma (peripheral-ICC). Some of so-called benign lesions such as bile duct adenoma, von Meyenburg complex, and biliary adenofibroma are occasionally followed by the development of peripheral-ICC, and some of low grade cholangiocarcinoma (cholangiolocellular carcinoma and cholangiocarcinoma with ductal plate malformation (DPM)-like features) are also followed by ordinary peripheral-ICC. In addition, bile duct adenoma-like lesion and atypical small bile duct lesions described here could be also related to the development of peripheral ICC. Unidentified factors or lesions and may also be involved in the development of peripheral ICC.
Mentions: In conclusion, several precursor or early neoplastic lesions of peripheral ICC reported in the literature were reviewed in the present study (Figure 8). Bile duct adenoma, biliary adenofibroma, and VMCs are reportedly associated with histologic features of malignancy or borderline lesions, and these lesions may be followed by carcinoma in a minority of peripheral ICC. Survey of unusual or atypical biliary lesions in peripheral ICC showed that bile duct adenoma-like lesions and atypical biliary lesions of small bile ducts were not infrequent in the background liver, possibly related to the development of peripheral ICC. In addition, several borderline or low grade biliary malignancies such as CLC or ICC with DPM-like structures frequently contain the foci of ordinary peripheral ICC, suggesting their transition to peripheral ICC and multistep cholangiocarcinogenesis. In hilar and extrahepatic CCs, the precursor lesions such as BilIN and IPN of bile duct are now being recognized and have been studied actively. More extensive surveys on precursor or premalignant lesions as well as more sophisticated studies based on pathologically confirmed precursor lesions in peripheral ICC as well as on those in hilar and extrahepatic CCs may lead to the earlier detection of and a better prognosis after surgical resection of peripheral ICC and hilar and extrahepatic CCs.

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