Hyungjin Rhee1, Myeong-Jin Kim2, Young Nyun Park3,4, Chansik An1. 1. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-gu, Seoul, 03722, South Korea. 2. Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-gu, Seoul, 03722, South Korea. kimnex@yuhs.ac. 3. Department of Pathology, Brain Korea 21 PLUS Project for Medical Science, Integrated Genomic Research Center for Metabolic Regulation, Yonsei University College of Medicine, Seoul, South Korea. 4. Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
Abstract
OBJECTIVES: To investigate the clinicopathologic significance of a subclassification of mass-forming intrahepatic cholangiocarcinoma (MF-iCCA) into ductal and parenchymal types based on magnetic resonance imaging (MRI) METHODS: We enrolled 72 consecutive patients, in whom MF-iCCA was diagnosed on preoperative MRI and surgical resection from January 2000 to March 2013. Two readers independently evaluated MRI findings of adjacent bile duct dilation, periductal tumor spread, and presence of diffuse dilatation or abnormality of the intrahepatic bile duct. MF-iCCAs with none of the aforementioned findings were defined as parenchymal type, and those with one or more findings were defined as ductal type. The enhancement pattern in the arterial phase was also evaluated. Clinical and histopathological findings, as well as post-surgical outcomes, were collected from medical records. RESULTS: Parenchymal-type MF-iCCA (21/78, 27%) exhibited significantly lower serum carbohydrate antigen 19-9 (12.8 vs. 173.8 U/mL) and carcinoembryonic antigen (1.7 vs. 4.2 ng/mL), more frequent viral hepatitis (43% vs. 18%), less frequent biliary intraepithelial neoplasia (0% vs. 26%), and less frequent perineural invasion (0% vs. 59%) and lymph node metastasis (7% vs. 46%), compared with the ductal type (57/78, 73%) (p < 0.05 for all). Parenchymal-type MF-iCCA showed more frequent arterial hypervascularity (p = 0.001) and better overall survival (p = 0.030) than the ductal type. CONCLUSION: Subclassification of MF-iCCAs into parenchymal and ductal types may be useful to discriminate clinical and histopathological characteristics and post-surgical outcomes. KEY POINTS: • We propose subclassification of mass-forming intrahepatic cholangiocarcinoma (MF-iCCA) as parenchymal and ductal types, on the basis of magnetic resonance imaging findings of biliary abnormality. • Two types of MF-iCCAs exhibit different clinical and histopathological characteristics and post-surgical outcomes.
OBJECTIVES: To investigate the clinicopathologic significance of a subclassification of mass-forming intrahepatic cholangiocarcinoma (MF-iCCA) into ductal and parenchymal types based on magnetic resonance imaging (MRI) METHODS: We enrolled 72 consecutive patients, in whom MF-iCCA was diagnosed on preoperative MRI and surgical resection from January 2000 to March 2013. Two readers independently evaluated MRI findings of adjacent bile duct dilation, periductal tumor spread, and presence of diffuse dilatation or abnormality of the intrahepatic bile duct. MF-iCCAs with none of the aforementioned findings were defined as parenchymal type, and those with one or more findings were defined as ductal type. The enhancement pattern in the arterial phase was also evaluated. Clinical and histopathological findings, as well as post-surgical outcomes, were collected from medical records. RESULTS: Parenchymal-type MF-iCCA (21/78, 27%) exhibited significantly lower serum carbohydrate antigen 19-9 (12.8 vs. 173.8 U/mL) and carcinoembryonic antigen (1.7 vs. 4.2 ng/mL), more frequent viral hepatitis (43% vs. 18%), less frequent biliary intraepithelial neoplasia (0% vs. 26%), and less frequent perineural invasion (0% vs. 59%) and lymph node metastasis (7% vs. 46%), compared with the ductal type (57/78, 73%) (p < 0.05 for all). Parenchymal-type MF-iCCA showed more frequent arterial hypervascularity (p = 0.001) and better overall survival (p = 0.030) than the ductal type. CONCLUSION: Subclassification of MF-iCCAs into parenchymal and ductal types may be useful to discriminate clinical and histopathological characteristics and post-surgical outcomes. KEY POINTS: • We propose subclassification of mass-forming intrahepatic cholangiocarcinoma (MF-iCCA) as parenchymal and ductal types, on the basis of magnetic resonance imaging findings of biliary abnormality. • Two types of MF-iCCAs exhibit different clinical and histopathological characteristics and post-surgical outcomes.
Entities:
Keywords:
Bile duct diseases; Bile ducts; Liver neoplasms; Magnetic resonance imaging; Prognosis
Authors: Mina Komuta; Olivier Govaere; Vincent Vandecaveye; Jun Akiba; Werner Van Steenbergen; Chris Verslype; Wim Laleman; Jacques Pirenne; Raymond Aerts; Hirohisa Yano; Frederik Nevens; Baki Topal; Tania Roskams Journal: Hepatology Date: 2012-06 Impact factor: 17.425
Authors: Ju Gang Nam; Jeong Min Lee; Ijin Joo; Su Joa Ahn; Jin Young Park; Kyoung Bun Lee; Joon Koo Han Journal: J Comput Assist Tomogr Date: 2018 May/Jun Impact factor: 1.826
Authors: Jesper B Andersen; Bart Spee; Boris R Blechacz; Itzhak Avital; Mina Komuta; Andrew Barbour; Elizabeth A Conner; Matthew C Gillen; Tania Roskams; Lewis R Roberts; Valentina M Factor; Snorri S Thorgeirsson Journal: Gastroenterology Date: 2011-12-13 Impact factor: 22.682
Authors: Chansik An; Chang Hee Lee; Jae Ho Byun; Min Hee Lee; Woo Kyoung Jeong; Sang Hyun Choi; Do Young Kim; Young Suk Lim; Young Seok Kim; Ji Hoon Kim; Moon Seok Choi; Myeong Jin Kim Journal: Korean J Radiol Date: 2019-12 Impact factor: 3.500