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Difference between revisions of "Cholangiocarcinoma"
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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). | 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). | ||
[[File:1 Cholangio 4 680x512px.tif| Cholangiocarcinoma with associated abscess]] | |||
[[File:2 Cholangio 4 680x512px.tif| Cholangiocarcinoma with associated abscess]] | |||
[[File:3 Cholangio 4 680x512px.tif| Cholangiocarcinoma with associated abscess]] | |||
[[File:4 Cholangio 4 680x512px.tif| Cholangiocarcinoma with associated abscess]] | |||
[[File:5 Cholangio 4 680x512px.tif| Cholangiocarcinoma with associated abscess]] | |||
[[File:6 Cholangio 4 680x512px.tif| Cholangiocarcinoma with associated abscess]] | |||
Cholangiocarcinoma, intrahepatic, with associated abscess. A. Aberrant spaces (arrows) contrast with the scar to the regions left and, at right, hemosiderin laden macrophages amid granulation tissue [40X]. B1. Disorderly spreading glands (black arrows) associated with atypical single cells (cyan arrows) have nuclei that contrast with those of the normal bile duct (blue arrow) with its associated artery (green arrow) [200X]. C. PAS without diastase shows disorderly spreading, aberrantly shaped glands at left (arrows) and red degenerated hepatocytes to right [200X]. D. PAS with diastase shows proliferating bile ducts to left, one with highly aberrant nuclei (black arrow), highly atypical cells at middle (green arrows) with sometimes incomplete (cyan arrows) acini, and normal liver at right (blue arrow) [200X]. E. CK7 immunostain shows proliferating glands at left and a disorderly spread of single cells and cell groups at right, amid hepatocytes [200X]. F. CK7 immunostain at higher power shows the stained cells have aberrant nuclei [400X]. | |||
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