Intrahepatic cholangiocarcinoma with predominant "ductal plate malformation" pattern: a new subtype.
Ten cases of intrahepatic cholangiocarcinoma showing a highly differentiated adenocarcinoma mimicking ductal plate malformation (DPM) are reported. The patients included 7 males and 3 females with an average age of 69.5 years. Six cases were associated with chronic liver disease and the remaining 4 cases showed mild fatty change in the parenchyma and/or minimal to mild portal inflammation. Grossly, the tumor was a single nodule 1.5 to 6.6 cm in diameter, and was whitish and solid without a fibrous capsule. Microscopically, the tumor was composed of many vague, small nodular carcinomatous areas with desmoplastic reactions, and neoplastic glands had an irregularly dilated lumen lined with a single layer of cuboidal or low columnar carcinoma cells and irregular protrusions and bulges, resembling DPM. At its border, the carcinoma seemed to replace the non-neoplastic hepatic lobules or regenerative nodules. The central parts of the tumor were variably hypocellular and fibrotic. Although these carcinomas were negative for mucin and HepParI, they were frequently positive for CK19, epithelial cell adhesion molecule, and epithelial membrane antigen. Neural cell adhesion molecule was also expressed variably. The Ki-67 labeling index was <10% and p53 was scarcely expressed. In conclusion, a new subtype of intrahepatic cholangiocarcinoma with predominant DPM pattern was identified.
Department of Human Pathology, Kanazawa University Graudate School of Medicine, Kanazawa, Japan. pbcpsc@kenroku.kanazawa-u.ac.jp
Yasuni
Y
Nakanuma
Yasunori
Y
Sato
Hiroko
H
Ikeda
Kenichi
K
Harada
Mikiko
M
Kobayashi
Kenji
K
Sano
Takeshi
T
Uehara
Masakazu
M
Yamamoto
Shunichi
S
Ariizumi
Young Nyun
YN
Park
Joon Hyuk
JH
Choi
Ensil
E
Yu
D000368:Aged; D000951:Antigens, Neoplasm / Q000378:metabolism; D001650:Bile Duct Neoplasms / Q000378:metabolism / Q000473:pathology*; D001653:Bile Ducts, Intrahepatic / Q000378:metabolism / Q000473:pathology*; D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules / Q000378:metabolism; D018281:Cholangiocarcinoma / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D002908:Chronic Disease; D000071858:Epithelial Cell Adhesion Molecule; D005234:Fatty Liver / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D008107:Liver Diseases / Q000150:complications / Q000473:pathology; D008297:Male; D018396:Mucin-1 / Q000378:metabolism
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015815:Cell Adhesion Molecules; D000071858:Epithelial Cell Adhesion Molecule; D053539:Keratin-19; D019394:Ki-67 Antigen; D018396:Mucin-1