title: Intrahepatic cholangiocarcinomas in cirrhosis are hypervascular in comparison with those in normal livers.
abstract: OBJECTIVE
  Intrahepatic cholangiocarcinomas (ICCs) are usually adenocarcinomas with fibrotic and hypovascular stroma. Intrahepatic cholangiocarcinomas in cirrhosis and precirrhotic liver (ICC-cirrhosis) are increasingly being diagnosed, and can display hypervascular enhancement resembling a hepatocellular carcinoma on dynamic imaging.
  
  
  METHODS
  In this study using ICC-cirrhosis (71 cases), ICC with non-specific reactive changes (ICC-reactive) (72 cases) and the cholangiocarcinoma component of combined hepatocellular cholangiocarcinoma (HCC-ICC) (30 cases), we tried to compare the tumour vasculature.
  
  
  RESULTS
  It was found that ICC-cirrhosis and the cholangiocarcinoma component of HCC-ICC showed a higher density of arteries and microvessels (1.59 ± 0.58/mm(2) (mean ± SD) and 140 ± 43/mm(2) in ICC-cirrhosis and 1.74 ± 0.67/mm(2) and 131 ± 46/mm(2) in the cholangiocarcinoma component of HCC-ICC) than in ICC-reactive (1.26 ± 0.61/mm(2) and 103 ± 45/mm(2) ). Dynamic computed tomography (CT) and magnetic resonance imaging (MRI) showed that a majority of ICC-cirrhosis displayed strong hypervascular enhancement, whereas one-third of ICC-reactive each showed strong, weak and no or minimal enhancement respectively. The increased vascular density was positively correlated with enhanced arterial phase of dynamic CT and MRI.
  
  
  CONCLUSIONS
  The density of arteries and microvessels of ICC-cirrhosis was higher than that in ICC-reactive and comparable to that in the cholangiocarcinoma component of HCC-ICC, and the higher density of arteries and microvessels in ICC may be responsible for the hypervascular enhancement of ICC-cirrhosis.
authors.affiliation: Department of Human Pathology, Kanazawa University Hospital, Kanazawa, Japan.
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.forename: Saya
authors.initials: S
authors.lastname: Igarashi
authors.forename: Motoko
authors.initials: M
authors.lastname: Sasaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsubara
authors.forename: Norihide
authors.initials: N
authors.lastname: Yoneda
authors.forename: Kazuto
authors.initials: K
authors.lastname: Kozaka
authors.forename: Hiroko
authors.initials: H
authors.lastname: Ikeda
authors.forename: Jihun
authors.initials: J
authors.lastname: Kim
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yu
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
authors.forename: Yasuni
authors.initials: Y
authors.lastname: Nakanuma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D018281:Cholangiocarcinoma / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods