Clinical and biological significance of precursor lesions of intrahepatic cholangiocarcinoma - PubMed (original) (raw)

Clinical and biological significance of precursor lesions of intrahepatic cholangiocarcinoma

Mark Ettel et al. World J Hepatol. 2015.

Abstract

Cholangiocarcinoma (CC) is primarily a malignant tumor of older adults most prevalent in Southeast Asia, where liver fluke infestation is high. However the etiology in western countries is unknown. Although the incidence of extrahepatic cholangiocarcinoma has remained constant, incidence of intrahepatic CC (ICC) which differs in morphology, pathogenesis, risk factors, treatment and prognosis is increasing. While this increase is associated with hepatitis C virus infection, chronic nonalcoholic liver disease, obesity, and smoking, the pathogenesis of ICC and molecular alterations underlying the carcinogenesis are not completely elucidated. Benign biliary lesions such as biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct, von Meyenburg complex or bile duct hamartoma, and bile duct adenoma have been associated with ICC. For each of these entities, evidence suggests or supports a role as premalignant lesions. This article summarized the important biological significance of the precursor lesions of ICC and the molecular mechanisms that may be involved in intrahepatic cholangiocarcinogenesis.

Keywords: Bile duct adenoma; Intraductal papillary neoplasm of the bile duct; Intraepithelial neoplasia; Intrahepatic cholangiocarcinoma; Von Meyenburg complex or bile duct hamartoma.

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Figures

Figure 1

Figure 1

Premalignant biliary lesions. A: Biliary intraepithelial neoplasia. Biliary epithelium with nuclear pseudostratification and atypia; B: Intraductal papillary neoplasm of the bile duct. Papillary proliferation of neoplastic cells lining thin fibrovascular cores; C: Von Meyenburg complex. Small well-circumscribed lesion consisting of dilated irregular bile ducts embedded within dense collagenous stroma; D: Bile duct adenoma. Well-circumscribed proliferation of small uniform tubules surrounded by fibrous stroma.

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