A bile duct lesion originating from intrahepatic bile ducts is generally regarded as an incidental pathologic finding in liver specimens. However, a recent study on the molecular classification of intrahepatic cholangiocarcinoma has focused on the heterogeneity of this carcinoma and has suggested that the cells of different origins present in the biliary tree may have a major role in the mechanism of oncogenesis. In this review, benign intrahepatic bile duct lesions—regarded in the past as reactive changes or remnant developmental anomalies and now noted to have potential for developing precursor lesions of intrahepatic cholangiocarcinoma—are discussed by focusing on the histopathologic features and its implications in clinical practice.
Bile Duct Neoplasms/*pathology ; Bile Ducts/pathology ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*pathology ; Diagnosis, Differential ; Humans ; Liver/pathology

At present, the classification, nomenclature, and definition of carcinoma of the bile ducts are controversial. Moreover, there is no uniformity between China and aboard, which has brought confusion to clinical practice. It needs to clarify regarding tumor naming principles, anatomical location, tumor origin, pathological classification, biological characteristics, clinical manifestations, treatment methods, etc. Additionally, the WHO tumor classification, UICC staging, ICD disease classification, relevant Chinese regulations, EASL, AJCC staging, and NCCN guidelines were also needed to be referred. After investigating the above-mentioned latest authoritative literature, based on the existing problems, combined with clinical practice in China, the author reevaluated the definition, classification, and nomenclature of cholangiocarcinoma, and proposes updated suggestions. Hoping to standardize and unify clinical practice for classification and nomenclature of cholangiocarcinoma in China.
Bile Duct Neoplasms/pathology* ; Bile Ducts/pathology* ; Bile Ducts, Intrahepatic/pathology* ; China ; Cholangiocarcinoma/pathology* ; Humans ; Neoplasm Staging ; Prognosis

Bile Duct Neoplasms/pathology* ; Bile Ducts, Intrahepatic/pathology* ; Cholangiocarcinoma/pathology* ; Consensus ; Humans

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary malignant tumor in the liver after hepatocellular carcinoma. Its incidence and mortality rates have increased worldwide in recent years. Surgical resection is the best treatment modality for ICC;however,the overall prognosis remains poor. Accurate evaluation of post operative prognosis allows personalized treatment and improved long-term outcomes of ICC. The American Joint Commission on Cancer TNM staging manual is the basis for the standardized diagnosis and treatment of ICC;however,the contents of stage T and stage N need to be improved. The nomogram model or scoring system established in the analysis of commonly used clinicopathological parameters can provide individualized prognostic evaluation and improve prediction accuracy;however,more studies are needed to validate the results before clinical use. Meanwhile,imaging features exhibit great potential to establish the post operative prognosis evaluation system for ICC. Molecular-based classification provides an accurate guarantee for prognostic assessment as well as selection of populations that are sensitive to targeted therapy or immunotherapy. Therefore,the establishment of a prognosis evaluation system,based on clinical and pathological characteristics and centered on the combination of multidisciplinary and multi-omics,will be conducive to improving the long-term outcomes of ICC after surgical resection in the context of big medical data.
Humans ; Bile Ducts, Intrahepatic/pathology* ; Cholangiocarcinoma/pathology* ; Prognosis ; Liver Neoplasms/surgery* ; Bile Duct Neoplasms/pathology*

Hilar cholangiocarcinoma represent the majority of cholangiocarcinoma, accounting for 40-60% of whole cases. Complete resection remains the most effective and only potentially curative therapy for cholangiocarcinoma. Important factors for resection of cholangiocarcinoma such as diagnostic methods and clinical staging has been improved. Cancer staging system should be useful for guiding treatment and predicting the chance of survival. After Bismuth-Corlette classification was reported, several staging systems has been proposed and updated to accomplish this purpose. Currently 6th ed. American Joint Committee on Cancer (AJCC) staging, 2nd ed. Japanese Society of Biliary Surgery (JSBS) classification and modified Memorial Sloan-Kettering Cancer Center (MSKCC) classification are used worldwide for staging of hilar cholangiocarcinoma. These systems consider not only the tumor extent but also local biological factors that affect the resectability, but the priority among them has not yet been evaluated and randomized studies are being expected to verify this.
Bile Duct Neoplasms/classification/*pathology ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/classification/*pathology/secondary ; Humans ; Neoplasm Staging

Bile Duct Neoplasms ; pathology ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; pathology ; surgery ; Humans

No abstract available.
Aged ; *Bile Duct Neoplasms/diagnosis/pathology ; *Bile Ducts, Intrahepatic ; *Cholangiocarcinoma/diagnosis/pathology ; Humans ; Male

Three siblings with congenital dilatation of the intrahepatic bile ducts (Caroli's disease) are presented. Bile duct pathology was associated with congenital hepatic fibrosis and polycystic renal disease in all three patients. On color Doppler imaging (CD imaingl, multiple small color Doppler signals were observed in or near the vascular radicles within the dilated bile ducts, besides other well-known sonographic findings such as bile duct dilatations, biliary calculi. Dopper frequency spectral analysis confirmed all these color Doppler signals as arterial origin in all patients, showing pulsatile wave pattern. Although portal venous radicles are well known in conventional sonograms or computed tomotraphy(CT), continuous wave patterns were not detected in all patients. In addition to previously reported sonographic findings about Caroli's disease, color Doppler signals showing arterial wave pattern in or around the portal venous radicles within dilated duets are another helpful diagnostic criteria and these findings are easily depicted on routine sonograms with color mapping.
Bile Ducts* ; Bile Ducts, Intrahepatic ; Bile* ; Caroli Disease* ; Dilatation ; Fibrosis ; Gallstones ; Humans ; Pathology ; Polycystic Kidney Diseases ; Siblings ; Ultrasonography

BACKGROUND: Knowledge of bile duct anatomy is largely obtained through cholangiography. However, it is sometimes difficult to follow the intrahepatic segmental bile ducts and to define the extent of pathology precisely. Basically, the images on cholangiography are projected ones, so they do not provide the spatial concept. In contrast, sequential slices of CT contain information on the threedimensional structure. Purpose : We aimed to assess the intrahepatic bile duct anatomy by examining the CT. METHODS: The spiral CT images of 42 patients with bile duct dilatation were examined serially from above downward. Intrahepatic bile ducts were followed up to the third-order branches, classified according to the level of branching and compared with those on cholangiography. Further, the relationship between the segmental bile ducts and portal veins were evaluated. RESULTS: At or below the level of convergence of the ventral(V) and dorsal(D) branches of VIII segment, the posterior bile duct(Bp) arises from right or common hepatic duct(VDP, or VD-P). Below this level, the Bp descends more than 8mm and branches into VI segmental branch(B6) and the posterior trunk(Pr), or it branches directly into B6 and Pr without definite descending portion(Pd). VDP-Pd- Pr,B6(high level of branching of Bp with Pd) was observed in 22, VDP-Pr,B6(high level of branching of Bp without Pd) in 3, VD-P-Pd-Pr,B6(low level of branching of Bp with Pd) in 12, and VD-P-Pr,B6(low level of branching of Bp without Pd) in 4. These findings were closely correlated with those on cholangiography. Regarding the relationship of the segmental bile ducts and portal veins(PV), all right anterior bile ducts were located superior-medial to the PV, and the trunk of right posterior bile duct(Pr) ran superior-lateral to PV in 38 and superior-medial in 4 patients. Most segmental branches of VI and VII segments ran anterior-lateral-superior to PV(VI:39/40, VII:17/18). The Bp coursed above(and behind) the right anterior portal vein(APV) in 39, and below(and in front of) the APV in 3, of which 2 cases had separate and low origin of Bp from common hepatic duct. CONCLUSION: CT was useful to understand intrahepatic bile duct anatomy.
Bile ; Bile Ducts ; Bile Ducts, Intrahepatic* ; Cholangiography ; Dilatation ; Hepatic Duct, Common ; Humans ; Pathology ; Portal Vein ; Tomography, Spiral Computed

Bile Duct Neoplasms ; diagnosis ; Bile Ducts, Intrahepatic ; pathology ; Cholangiocarcinoma ; diagnosis ; Humans ; In Situ Hybridization, Fluorescence