Carcinoma of the biliary tract complicating chronic ulcerative colitis (original) (raw)
Three autopsied cases of carcinoma of the bile ducts or gallbladder in rela-tiveIy young individuals with longstanding ulcerative colitis are described. Recent reports of the frequent occurrence of biliary tract disease in patients with ulcerative colitis and the association of chronic biliary inflammation with tumors suggest that neoplasia of the biliary tree may represent an additional extracolonic complication of chronic inflammatory bowel disease. UMEKOUS AUTOPSY AND BIOPSY OBSERVA-N tions have established an association between chronic ulcerative colitis and various manifestations of hepatic and biliary tract injury. These include fatty infiltration, abscess and cirrhosis of the liver, and nonspecific pericholangitis and chronic sclerosing cholangitis. Several recent reports indicate that neoplasms of the biliary tract should be added to the list. T h e present paper deals with 3 cases of biliary tract carcinoma associated with chronic ulcerative colitis in relatively young individuals. One had an intrahepatic cholangiolar carcinoma, one a carcinoma of a hepatic duct, and the third a carcinoma of the gallbladder. CASE REPORTS Case 1. Intrahepatic cholangiolul-ca~cinoma: This 31-year-oId Caucasian man first became ill at age 12, when he was noted to have hepatosplenomegaly, leukopenia, and thrombocytopenia. A liver biopsy performed at the time of splenectomy revealed recognizable hepatic architec ture, but extensive portal fibrosis was seen with porto-portal bridging and focal swelling or degeneration of hepatocytes at the limiting plate. A history of recurrent diarrhea prompted a proctoscopic examination, and a diagnosis of chronic ulcerative colitis was establi5hed. During the next 17 years, the patient was hospital-From the 1:niversit)of Chicago, Chicago, Ill.
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