A histopathological study on combined hepatocellular and cholangiocarcinoma: cholangiocarcinoma component is originated from hepatocellular carcinoma.

摘要: BACKGROUND/AIMS Combined hepatocellular and cholangiocarcinoma of the liver is relatively infrequent, its pathogenesis remains obscure. The aim this study to investigate clinical pathological features proliferative activity. METHODOLOGY In study, we investigated histopathological features, Ki-67 labeling index, p53 immunohistochemistry 18 surgically resected cases combined among 1102 consecutive primary cancers. All tumors were compatible with WHO definition tumor. Microscopically, classified into following three categories according arrangement carcinoma components; (1) Type I in which formed nodules that could easily be distinguished from each other, (2) II both components finely mixed, so two almost indistinguishable, (3) III had lobular structures carcinomas existing centrally cholangiocarcinomas peripherally. RESULTS type 7 tumors, 5 6 tumors. one case I, well differentiated demonstrated "nodules-in-nodules" fashion. average index component was 4.4 +/- 3.4% 11.0 8.5%, significantly higher than component. On immunohistochemistry, (29.4%) positive. case, positive for p53, but negative. other 4 cases, CONCLUSIONS seems a feature metaplasia or proliferation bipotential progenitor cells. Metaplasia intrahepatic assumed pathogenic pathways cholangiocarcinoma.