Diffuse mucosal carcinoma of intrahepatic and extrahepatic bile ducts including gallbladder.
An autopsy case with a widespread mucosal carcinoma of the biliary tree was reported. A biochemical profile of the bile duct damage was noticed in a woman in her seventies during a gastric examination. Imaging procedures depicted irregular dilatations of intrahepatic bile ducts with a bead-like appearance. Elevated levels of serum alkaline phosphatase and gamma-glutamyltransferase with a negative antimitochondrial antibody persisted. The patient was diagnosed as primary sclerosing cholangitis, she was followed up for 4 years under preservative therapies, and died of anasarca and heart failure. Post-mortem examination showed a diffuse mucosal carcinoma of both intrahepatic and extrahepatic biliary passages including the gallbladder with a minimal invasion and scattered foci of adenoma-like area in part. There was no evidence of gallstones or pre-existing sclerosing cholangitis. The striking features of the tumor were extensive papillary growth, mucus secretion and irregular dilatation of bile ducts. The tumor may bear biological and morphological homology with intraductal papillary mucinous tumor of the pancreas.
Haratake
Joji
J
Department of Pathology, Kurobe City Hospital, Kurobe, Japan. pathol@med.kurobe.toyama.jp
Kasai
Takahiko
T
Makino
Hiroshi
H
D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001650:Bile Duct Neoplasms / Q000097:blood / Q000473:pathology*; D017734:Bile Ducts, Extrahepatic / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000097:blood / Q000473:pathology*; D002758:Cholangiography; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D009092:Mucous Membrane / Q000473:pathology; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase