J Pathol Transl Med.  2015 Nov;49(6):531-534. 10.4132/jptm.2015.06.19.

Intrahepatic Cholangiocarcinoma with Ductal Plate Malformation-like Feature Associated with Bile Duct Adenoma

• Kwon AY
• Lee HJ
• An HJ
• Kang H
• Heo JH
• Kim G

• KMID: 2381413
• DOI: http://doi.org/10.4132/jptm.2015.06.19

Abstract

No abstract available.

MeSH Terms

Adenoma, Bile Duct*
Bile Ducts*
Bile*
Cholangiocarcinoma*

Figure

• 

  Fig. 1. Radiologic and gross findings. (A) Magnetic resonance imaging of the liver reveals a 2-cm target appearance lesion (arrow) in segment 4. On a T1-weighted image, the central portion shows low signal intensity (SI), and the peripheral zone shows intermediate to slightly high SI. (B) Grossly, the tumor is a relatively well-defined, solid, pale brown mass with a multinodular margin and central fibrous scar. The tumor has three areas: double line of right upper area, cholangiocarcinoma; dotted central circle, dilated ducts with fibrous stroma; and line of left lower area, bile duct adenoma.

• 

  Fig. 2. Microscopic findings of the tumor. (A) One peripheral portion shows highly packed ducts with bland looking nuclei; bile duct adenoma containing portal tracts (arrow). (B) Central area reveals irregularly dilated glandular structures within fibrous stroma, resembling features of ductal plate malformation. (C) In the other peripheral lesion, fused and cribriform glands infiltrate into the stroma. The nuclei are atypical and show brisk mitotic activity; cholangiocarcinoma. (D) The tumor shows a transitional area between bile duct adenoma (right) and cholangiocarcinoma(left). Bland uniform ductal structures become irregular and anastomosing.

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  Fig. 3. Immunohistochemical staining patterns in three areas. Cytokerain 19 (CK19) and polyclonal carcinoembryonic antigen (CEA) are positive in all areas, but intensity and location are different. Epithelial membrane antigen (EMA) and NCAM are negative in the bile duct adenoma (BDA) area, weakly positive in the ductal plate malformation (DPM) area, and positive in the cholangiocarcinoma (ICC) area. The Ki-67 labeling index differs in the different areas, from 1%–2% in BDA to 40%–50% in the cholangiocarcinoma area.

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