Combined hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) is sometimes found in resected livers, however, cases with double cancer of HCC and CC are very rare. As well, the rarity of CC arising in von Meyenburg complexes (VMCs) is appreciated. We report the case of a 74-year-old man found to have intrahepatic double cancer composed of well-differentiated HCC and CC which exhibited a histologic progression from VMCs to adenomatous lesions and CC. To our knowledge, this is the first case report published in the literature of a double HCC and CC associated with multiple VMCs. The pathogenesis and previous associated reports of these lesions are discussed.
Aged ; Bile Ducts, Intrahepatic/abnormalities* ; Carcinoma, Hepatocellular/pathology* ; Carcinoma, Hepatocellular/etiology ; Case Report ; Cholangiocarcinoma/pathology* ; Cholangiocarcinoma/etiology ; HumanLiver Neoplasms/pathology* ; Liver Neoplasms/etiology ; Male ; Neoplasms, Multiple Primary/pathology* ; Neoplasms, Multiple Primary/etiology

No abstract available.
Aged ; Bile Duct Neoplasms/etiology/*pathology ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma/etiology/*pathology ; Hamartoma/complications/pathology ; Humans ; Immunohistochemistry ; Liver/pathology/surgery ; Male ; Tomography, X-Ray Computed

No abstract available.
Bile Duct Neoplasms/complications/*diagnosis/pathology ; *Bile Ducts, Intrahepatic/pathology ; Cholangiocarcinoma/complications/*diagnosis/pathology ; Female ; Humans ; Lithiasis/*etiology/pathology/surgery ; Liver Diseases/*etiology/pathology/surgery ; Middle Aged

Portal vein embolization (PVE) is known as an effective and safe preoperative procedure that increases the future liver remnant (FLR) in patients with insufficient FLR. However, some possible major complications can lead to non-resectability or delayed elective surgery that results in increased morbidity and mortality. Although the majority of these complications are rare, knowledge of the radiologic findings of post-procedural complications facilitate an accurate diagnosis and ensure prompt management. We accordingly reviewed the CT findings of the complications of PVE.
Aged ; Cholangiocarcinoma/radiography/therapy ; Embolization, Therapeutic/*adverse effects ; Female ; Humans ; Hypertension, Portal/etiology ; Liver Neoplasms/radiography/*therapy ; Male ; Middle Aged ; Portal Vein/*radiography ; Tomography, X-Ray Computed ; Vascular System Injuries/etiology ; Venous Thrombosis/etiology

Biliary drainage in patients with malignant biliary obstruction relieves jaundice and prevents the development of cholangitis or hepatic failure from biliary obstruction. Therefore, this may result in better quality of life along with survival prolongation. Biliary stent placement is an effective and safe measure for biliary decompression and is preferred than bypass surgery in high risk patients. Entero-biliary perforation-communication is one of the rare complications of biliary stent. We herein report a case of duodeno-biliary perforation-communication in patient with distal cholangiocarcinoma who presented with duodenal ulcer and obstruction, occurring 4 years later from the metallic biliary stent insertion. Patient was managed with a pyloric metal stent and conservative care.
Aged, 80 and over ; Bile Duct Neoplasms/complications/*diagnosis ; Bile Ducts, Intrahepatic/pathology ; Biliary Fistula/*diagnosis/etiology/pathology ; Cholangiocarcinoma/complications/*diagnosis ; Duodenal Diseases/*diagnosis/etiology/pathology ; Female ; Humans ; Intestinal Fistula/*diagnosis/etiology/pathology ; Stents/*adverse effects ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the down stream involvement of the bile duct in hepatolithiasis.

METHODSMechanical damage to bile duct epithelia and long standing cholangitis as result of hepatolithiasis play an important role in the carcinogenesis of bile duct epithelia and stricture of the intra- and extra-hepatic bile duct. Macromorphological and microscopic changes in bile duct mucosa of 100 consecutive patients with hepatolithiasis were investigated using intra- or post-operative cholangioscopy. Biopsy specimens of lesions obtained during cholangioscopy were studied with immunohistochemical staining and flow cytometry to determine proliferative activity and DNA content. Five cases of well-proven cholangiocarcinoma were simultaneously studied as controls.

RESULTSOf the 100 patients, those with chronic cholangitis accounted for 86% (86/100), proliferative lesions 11% (11/100), adenomatous polyps 1% (1/100), and adenocarcinoma 2% (2/100). The obvious mucosal lesion associated with hepatolithiasis was located down-stream of the bile duct, predominantly in the hilar region, e.g. orifices of the right/left hepatic duct and common hepatic duct (73% mucosa lesions in the hilar region). The intensity of cancer embryonic antigen stain and the proliferative cell nuclear antigen index increased with the development of bile duct lesions. Aneuploid DNA presented mainly in the high degree malignant adenocarcinomas (> 80% of cases).

CONCLUSIONSThe obvious mucosal lesions associated with hepatolithiasis were located down-stream of the bile duct, predominantly in the hilar region (73% of mucosal lesions). The proliferative activity of examined bile duct mucosa lesions increased with the development of pathological deterioration, which may contribute to the development of hilar bile duct stricture and hilar cholangiocarcinoma.

Adult ; Aged ; Bile Ducts ; pathology ; Carcinoembryonic Antigen ; analysis ; Cholangiocarcinoma ; etiology ; Humans ; Lithiasis ; complications ; pathology ; Liver Diseases ; complications ; pathology ; Middle Aged ; Proliferating Cell Nuclear Antigen ; analysis

Brugada syndrome can be unmasked by several conditions including a febrile state, marked leukocytosis, and electrolyte disturbances. Herein, we describe a 62-year-old man with cholangiocarcinoma in the first reported case of Brugada syndrome onset following photodynamic therapy.
Bile Duct Neoplasms/*drug therapy ; *Bile Ducts, Intrahepatic ; Brugada Syndrome/diagnosis/*etiology/therapy ; Cardiopulmonary Resuscitation ; Cholangiocarcinoma/*drug therapy ; Electrocardiography ; Fatal Outcome ; Fever/etiology ; Humans ; Klatskin's Tumor/*drug therapy ; Male ; Middle Aged ; Photochemotherapy/*adverse effects ; Predictive Value of Tests ; Treatment Outcome

OBJECTIVEIn order to study the diagnosis and treatment of HBV and HCV infection.

METHODSWe retrospectively analysed clinical data of 680 patients with cholangiocarcinoma from 1995 to 2001 and stated by SPSS software.

RESULTS(1) The fastigium of cholangiocarcinoma was 60 - 65 years old. The incidence of cholangiocarcinoma was higher in aged males and the sex ratio (male:female) was 1.36:1. (2) The proximal cholangiocarcinoma was most (41.6%) and distant cholangiocarcinoma was secondly (28.7%). (3) Most patients of cholangiocarcinoma were late. The resection rate was low and the rate of radical operation was 21.6% (147/680). (4) The incidence of proximal cholangiocarcinoma was higher in the positive Serologic marks for HBV and HCV and course of diseases was short. Moreover, the pathology of. positive Serologic marks for HBV and HCV trended to low-differentiation and invasion, metastasis and the resection rate was lower.

CONCLUSIONSCholangiocarcinoma is common in the aged males. The infection of HB(C)V and hilar cholangiocarcinoma are correlated and incline to the proximal bile duct. The hilar cholangiocarcinoma infected HB(C)V may have higher malignant degree in biological characteristics and more badly prognosis.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; epidemiology ; etiology ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; epidemiology ; etiology ; Female ; Hepatitis B ; complications ; Hepatitis C ; complications ; Humans ; Incidence ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVE To study the correlation between hepatic hilar cholangiocarcinoma and the infection of HB (C)V. METHODS Combined with clinical data, immunohistochemistry was used to detect HBXAg antigen and HCV-C protein in 68 formalin-fixed and paraffin-embedded samples of hilar cholangiocarcinoma. RESULTS Six cases(8.8%) were positive to HBXAg antigen and 24 cases (35.0%) to HCV-C protein respectively. One case was positive to both HBXAg antigen and HCV-C protein. There were statistical differences in differentiation and invasion, lymph node metastasis, treatment between hilar cholangiocarcinomas infected HB(C)V and those non-infected. CONCLUSIONS HBXAg antigen and HCV-C protein may play an important role in the pathogenesis of hilar cholangiocarcinoma. Hilar cholangiocarcinoma infected HB(C)V may have a high malignancy and more poor prognosis.
Adult ; Aged ; Animals ; Bile Duct Neoplasms ; etiology ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; etiology ; Female ; Hepatitis B ; complications ; Hepatitis C ; complications ; Humans ; Male ; Mice ; Middle Aged ; Trans-Activators ; analysis ; Viral Core Proteins ; analysis

OBJECTIVETo establish an experimental model for exploring the role of hepatitis C virus (HCV) in the development of cholangiocarcinoma.

METHODSRecombinant plasmids of HCV-C gene were constructed by molecular cloning techniques and identified by PCR and restriction enzyme mapping.The plasmids were then transfected into QBC939 cells (a cholangiocarcinoma cell line) by Lipofection. After selection with G418, resistant colonies were obtained and analyzed by immunocytochemistry and Western blotting. The morphology was observed by trans mission electron microscopy (TEM). The expression of NF-(k)B was detected by immunocytochemistry.

RESULTSRecombinant plasmid was shown by PCR and restriction enzyme mapping to carry the target gene. Moreover, it could efficiently express HCV-C protein in QBC939 cells. HCV-like particles were found in the cytoplasm by TEM, which were spherical with a diameter of 50-80 nm and possessed an outer membrane. Moreover, NF-(k)B activation could be shown in HCV core-transfected cells.

CONCLUSIONExpression of the HCV-C gene in cholangiocarcinoma cells was achieved. Transfected tumor cells (QBC939-HCVc) could be used as a model to study the effect of HCV on the development of cholangiocarcinoma.

Bile Duct Neoplasms ; chemistry ; etiology ; virology ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; chemistry ; etiology ; virology ; Humans ; NF-kappa B ; analysis ; Plasmids ; Polymerase Chain Reaction ; Transfection ; Tumor Cells, Cultured ; Viral Core Proteins ; genetics ; physiology