Difference between revisions of "Cholangiocarcinoma"

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[[File:7 CCA 1 1360x1024px.tif| Cholangiocarcinoma, intrahepatic, large duct type.]]

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Cholangiocarcinoma, intrahepatic, large duct type. Extremely unfortunate case arising in a pre-teenage girl. MRI showing multiple hepatic masses. Histologic images. A mass comprising often large ducts abuts uninvolved liver (Row 1 Left 40X). CK7 immunostain emphasizes large, often adjoining ducts (Row 1 Right 40X). Trichrome stain shows spread of tumor into scar with collagen deposition (Row 2 Left 100X). Reticulin stain emphasizes disorderly vertical and horizontal spread of bizarrely shaped acini (Row 2 Right 100X). PAS-D stain shows luminal mucin; note absence of red lining of outside of ducts seen in normal bile ducts/proliferating bile ductules (Row 3 Left 200X). Loss of polarity (varied orientation with respect to base of epithelium) and variable size and shape of nuclei are obvious (Row 3 Right 400X, high pixel image).

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[[File:1 cholangio 2 680x512px.tif| Cholangiocarcinoma, intrahepatic, small duct type.]]

[[File:2 cholangio 2 680x512px.tif| Cholangiocarcinoma, intrahepatic, small duct type.]]

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[[File:3 cholangio 2 680x512px.tif|Cholangiocarcinoma, intrahepatic, small duct type.]]

[[File:4 cholangio 2 680x512px.tif|Cholangiocarcinoma, intrahepatic, small duct type.]]

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[[File:5 cholangio 2 680x512px.tif|Cholangiocarcinoma, intrahepatic, small duct type.]]

[[File:6 cholangio 2 680x512px.tif|Cholangiocarcinoma, intrahepatic, small duct type.]]

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Cholangiocarcinoma, intrahepatic, small duct type. Middle aged man with jaundice. Small dark tumorous masses [arrows] irrupt scar (Row 1 Left 20X). Cribriforming (net like pattern) of gland in gland [arrow] without intervening stroma, which can be difficult to discern from reactive bile ducts at times (Row 1 Right 100X). A second focus shows, on the left, glands with disorderly spread, further explored, and in the middle, partly formed glands with necrosis, further explored, both diagnostic (Row 2 Left 100X). Note how some glands go up and down [red arrows] & others go right to left [black arrows] showing disorderly spread (Row 2 Right 400X). Note necrotic cell nuclei [red arrows] and incompletely formed glands [black arrows] (Row 4 Left 200X). Nuclear anaplasia is also able to be used for a definite diagnosis, but there is considerable nuclear variability in reactive bile duct proliferations, making it less facile than disorderly spread, incomplete glands, and necrotic nuclei (Row 3 Right 400X).

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Difference between revisions of "Cholangiocarcinoma"

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@@ Line 96: / Line 96: @@
 [[File:7 CCA 1 1360x1024px.tif| Cholangiocarcinoma, intrahepatic, large duct type.]]
 |}
 Cholangiocarcinoma, intrahepatic, large duct type. Extremely unfortunate case arising in a pre-teenage girl.  MRI showing multiple hepatic masses. Histologic images. A mass comprising often large ducts abuts uninvolved liver (Row 1 Left 40X). CK7 immunostain emphasizes large, often adjoining ducts (Row 1 Right 40X). Trichrome stain shows spread of tumor into scar with collagen deposition (Row 2 Left 100X). Reticulin stain emphasizes disorderly vertical and horizontal spread of bizarrely shaped acini (Row 2 Right 100X). PAS-D stain shows luminal mucin; note absence of red lining of outside of ducts seen in normal bile ducts/proliferating bile ductules (Row 3 Left 200X).    Loss of polarity (varied orientation with respect to base of epithelium) and variable size and shape of nuclei are obvious (Row 3 Right 400X, high pixel image).
+{|
+[[File:1 cholangio 2 680x512px.tif| Cholangiocarcinoma, intrahepatic, small duct type.]]
+[[File:2 cholangio 2 680x512px.tif| Cholangiocarcinoma, intrahepatic, small duct type.]]
+<br>
+[[File:3 cholangio 2 680x512px.tif|Cholangiocarcinoma, intrahepatic, small duct type.]]
+[[File:4 cholangio 2 680x512px.tif|Cholangiocarcinoma, intrahepatic, small duct type.]]
+<br>
+[[File:5 cholangio 2 680x512px.tif|Cholangiocarcinoma, intrahepatic, small duct type.]]
+[[File:6 cholangio 2 680x512px.tif|Cholangiocarcinoma, intrahepatic, small duct type.]]
+|}
+Cholangiocarcinoma, intrahepatic, small duct type. Middle aged man with jaundice. Small dark tumorous masses [arrows] irrupt scar (Row 1 Left 20X). Cribriforming (net like pattern) of gland in gland [arrow] without intervening stroma, which can be difficult to discern from reactive bile ducts at times (Row 1 Right 100X). A second focus shows, on the left, glands with disorderly spread, further explored, and in the middle, partly formed glands with necrosis, further explored, both diagnostic (Row 2 Left 100X). Note how some glands go up and down [red arrows] & others go right to left [black arrows] showing disorderly spread (Row 2 Right 400X). Note necrotic cell nuclei [red arrows] and incompletely formed glands [black arrows] (Row 4 Left 200X). Nuclear anaplasia is also able to be used for a definite diagnosis, but there is considerable nuclear variability in reactive bile duct proliferations, making it less facile than disorderly spread, incomplete glands, and necrotic nuclei (Row 3 Right 400X).
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