Poorly differentiated adenocarcinoma with signet-ring cell carcinoma of the extrahepatic bile duct in a 42-year-old Japanese female: a case report.
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.
Ogata
Sho
S
Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan. sogata@ndmc.ac.jp
Kimura
Akifumi
A
Hatsuse
Kazuo
K
Yamamoto
Junji
J
Shimazaki
Hideyuki
H
Nakanishi
Kuniaki
K
Kawai
Toshiaki
T
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