title: Poorly differentiated adenocarcinoma with signet-ring cell carcinoma of the extrahepatic bile duct in a 42-year-old Japanese female: a case report.
abstract: Poorly differentiated adenocarcinoma without papilla or tubule formation of the extrahepatic bile duct is rare. Here we present a case (a 42-year-old Japanese woman) without either pancreatobiliary maljunction or liver disease. The patient had obstructive jaundice. Imaging studies revealed a bile duct tumor obstructing the common bile duct and invading the surrounding tissues. Pathologic examination revealed a dense periductal growth of poorly differentiated adenocarcinoma containing signet-ring cells, but without papilla or tubule formation in the extrahepatic bile duct. The tumor cells directly invaded the pancreatic parenchyma and the portal vein. In the extrahepatic bile duct, poorly differentiated adenocarcinoma may be established as a distinct clinicopathologic entity if the tumors are characterized by: 1) the absence of papilla or tubule formation, 2) Asian preponderance, 3) occurrence at a younger age than is usual for patients with biliary cancers, and 4) an aggressive mural invasiveness.
authors.affiliation: Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan. sogata@ndmc.ac.jp
authors.forename: Sho
authors.initials: S
authors.lastname: Ogata
authors.forename: Akifumi
authors.initials: A
authors.lastname: Kimura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hatsuse
authors.forename: Junji
authors.initials: J
authors.lastname: Yamamoto
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Shimazaki
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Kawai
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology*; D000328:Adult; D044466:Asian People; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000473:pathology*; D001706:Biopsy; D018279:Carcinoma, Signet Ring Cell / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D014057:Tomography, X-Ray Computed