1/561. Biliary papillary hyperplasia with clonorchiasis resembling cholangiocarcinoma.infection by the liver fluke clonorchis sinensis is very common in the far east. It causes low grade inflammatory changes and proliferation in the biliary tree. Initially there is desquamation of the biliary epithelium, followed by hyperplasia and adenomatous proliferation. Cholangiocarcinomas are potential long term complications. We present a case of biliary papillary hyperplasia with clonorchiasis resembling cholangiocarcinoma in a 69-yr-old Korean man. Early recognition of biliary hyperplasia and treatment of clonorchis sinensis is important to prevent development of cholangiocarcinoma, especially in the far east.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
2/561. Combined hepatocellular-cholangiocarcinoma. Diagnostic challenge in hepatic fine needle aspiration biopsy.OBJECTIVE: To study the cytohistologic features of combined hepatocellular-cholangiocarcinoma (CHCC-CC) in fine needle aspiration biopsy (FNAB) material. STUDY DESIGN: Six hepatic FNAB cases with cell blocks (five) and hepatic resections (two) were analyzed cytohistologically and immunohistochemically. RESULTS: The six cases were diagnosed as CHCC-CC based on clinicopathologic correlation. Unequivocal hepatocellular carcinoma (HCC) cells corresponding to Edmondson and Steiner's grade 3 lesions were identified in the FNAB in three instances. Adenocarcinoma, represented by cohesive columnar cells with ovoid, basal nuclei displaying nuclear palisading, acini and/or papillary structures with variable intracytoplasmic intraacinar or brush border mucin production, was identified in all cases. Intermediate cells with hybrid/polymorphic cytologic features straddling malignant hepatocytes and glandular cells were identified in five instances. Tissue alpha-fetoprotein was negative. There was brush border and/or diffuse cytoplasmic p-carcinoembryonic antigen immunoreactivity in the glandular elements. CONCLUSION: FNAB diagnosis of CHCC-CC is possible if the clinical, cytohistologic and immunohistochemical findings support the presence of HCC and adenocarcinoma. Intermediate cells pose a great challenge to recognize and define: they tend to lose the classic cytologic features of malignant hepatocytes and acquire glandular characteristics. At the very least, there should be a high index of suspicion. These cases underscore the necessity for clinicopathologic correlation in enhancing the precision of FNAB diagnoses.- - - - - - - - - - ranking = 1.1428571428571keywords = carcinoma (Clic here for more details about this article) |
3/561. Well-differentiated adenocarcinoma, gastric foveolar type, of the extrahepatic bile ducts: A previously unrecognized and distinctive morphologic variant of bile duct carcinoma.Two examples of a rare but distinctive morphologic variant of extremely well-differentiated adenocarcinoma of the extrahepatic bile ducts are reported. One tumor arose in the common bile duct of a 51-year-old man; the other arose in the common hepatic duct of a 27-year-old man. Both tumors were composed predominantly (>95%) of gastric foveolar-type epithelium. Because of their bland nuclear features, low mitotic index, and focal polypoid and lobular architecture, they were initially confused with adenomas. Foci of less-differentiated adenocarcinoma and perineural invasion present in the deep portions of the tumors facilitated recognition. The neoplastic cells and extracellular mucin were periodic acid-Schiff- and alcian blue-positive. By immunohistochemistry, the tumor cells expressed cytokeratins 8 and 20 as well as cathepsin d, as reported in normal foveolar cells. Likewise, p53 overexpression was documented immunohistochemically in both adenocarcinomas, which also stained with the Ki-67 antibody. Despite the well-differentiated nature of the neoplasms and their deceptively benign microscopic appearance, one patient developed recurrence and liver metastasis 5 years after surgery. The other patient is disease-free 2 years following a segmental resection of the common hepatic duct, cystic duct, and gallbladder. The cell phenotype of these tumors can be explained by the ability of the bile duct epithelium to differentiate along gastric cell lines.- - - - - - - - - - ranking = 1.5714285714286keywords = carcinoma (Clic here for more details about this article) |
4/561. Efficacy of applied cardiovascular surgery techniques for extended resection in hepato-biliary-pancreatic malignancies.The application of extracorporeal circulation (ECC) and vascular surgery techniques provide the possibility to resect severely advanced hepato-biliary-pancreatic (HBP) malignancies that had been adjudged unresectable hitherto. In this paper, recent two successful cases are reported for the purpose of indicating the efficacy of ECC and vascular surgery techniques in HBP surgery. Two patients had a cholangiocellular carcinoma and a carcinoma of the pancreatic head, those metastatic lymph nodes invaded to the portal veins and the hepatic arteries. These tumors could be resected en bloc with these Glissonian vessels using a centrifugal pump through veno-venous bypass. Reconstruction of these portal veins was performed with autologous external iliac vein graft. Postoperative angiographies showed no anastomotic leakage or occlusion on vascular anastomotic sites in both cases, and they have gone on uneventful postoperative courses. Application of cardiovascular techniques in the field of HBP surgery might expand surgical indication for advanced malignancies.- - - - - - - - - - ranking = 0.28571428571429keywords = carcinoma (Clic here for more details about this article) |
5/561. Percutaneous transheptic cholangioscopic ethanol injection for intrabiliary tumor thrombi due to hepatocellular carcinoma.Interventional treatments such as transcatheter arterial embolization and placement of a biliary endoprosthesis have been carried out in cases of inoperable hepatobiliary malignancy. We report here a case of recurrent intrabiliary tumor thrombi due to hepatocellular carcinoma, successfully treated by cholangioscopic ethanol injection in which the intrabiliary tumor thrombi were completely eliminated.- - - - - - - - - - ranking = 0.71428571428571keywords = carcinoma (Clic here for more details about this article) |
6/561. Hepatic arterial infusion chemotherapy of cisplatin for biliary cystadenocarcinoma.Biliary cystadenocarcinoma is a rare tumor which has a better prognosis after complete surgical removal. However, since there is no other effective therapeutic option instead of surgery, the prognosis is very poor if surgical resection is impossible. We report the case of a 78 year-old woman who was treated only by hepatic arterial infusion (HAI) chemotherapy of cisplatin (85 mg) because liver functional reserve was too bad to perform a major hepatectomy. Huge biliary cystadenocarcinoma occupying the right lobe of the liver measuring 12 cm in size before chemotherapy was drastically decreased to 2 cm in size 8 months after chemotherapy. Although she had abdominal pain and anorexia before chemotherapy, she is doing well and has no complaints 9 months after chemotherapy. In conclusion, an effective therapy may be possible using hepatic arterial infusion chemotherapy of cisplatin in patients with biliary cystadenocarcinoma for whom surgical treatment is not suitable.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
7/561. Carcinoma of the cystic duct associated with opisthorchiasis.Four patients who had obstructing carcinoma of the cystic duct and who presented themselves with enlarged and palpable gall bladders but without jaundice are reported. All patients came from endemic areas of opisthorchiasis and had evidence of opisthorchis infection by peritoneoscopic and surgical findings. All but one had opisthorchis eggs in the stool. The pathogenesis and management was discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = carcinoma (Clic here for more details about this article) |
8/561. Biliary cystadenocarcinoma: sonographic and cytologic findings.Biliary cystadenocarcinoma is a rare hepatic cystic tumor. We report sonographic, CT, and MRI findings in an unusual case in an 87-year-old man. The diagnosis was aided by sonographically guided needle aspiration of the lesion, which revealed elevated levels of carcinoembryonic antigen and CA 19-9 in the cystic fluid.- - - - - - - - - - ranking = 0.71428571428571keywords = carcinoma (Clic here for more details about this article) |
9/561. Case report: two cases of biliary papillomatosis with unusual associations.Papillomatosis arising from the biliary tree is a well recognized but rare entity. We encountered two patients with this condition. However, one of them had associated hepatocellular carcinoma and cirrhosis and the other had concomitant recurrent pyogenic cholangitis. To our knowledge, these associations have not been reported before. We, therefore, present these clinical problems and highlight the added difficulty in the management of these patients.- - - - - - - - - - ranking = 0.14285714285714keywords = carcinoma (Clic here for more details about this article) |
10/561. Pulmonary lymphangitis carcinomatosa and acute pancreatitis: a rare presentation of choledochal cyst.Pulmonary lymphangitis carcinomatosa is an unusual cause of death in a young adult. This case describes an apparently healthy young woman who presented with severe acute pancreatitis, which is a recognized complication of a choledochal cyst. autopsy examination revealed advanced malignancy with poorly differentiated adenocarcinoma penetrating the wall of the choledochal cyst and metastatic adenocarcinoma in the lymph nodes, lungs and kidneys. This case emphasises the unusual presentation of a choledochal cyst with acute pancreatitis and the aggressive nature of malignancy associated with this congenital anomaly.- - - - - - - - - - ranking = 1keywords = carcinoma (Clic here for more details about this article) |
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