3-DIMENSIONAL RECONSTRUCTION OF PERINEURAL INVASION IN CARCINOMA OF THE EXTRAHEPATIC BILE-DUCTS

Three-dimensional (3D) reconstruction can be used to study the structu ral relationships between various tissue components and can help in th e understanding of disease processes, Examples of perineural invasion have been reconstructed in two cases of adenocarcinoma of the extrahep atic bile duct, Ninety-six serial 5 mu m sections were taken from both cases stored on file and 3D images were constructed using a Kontron V IDAS image analysis system, Both cases showed continuity of tumour cel ls within the perineural space, The isolated islands of malignant glan ds seen by conventional microscopy were shown to be in continuity with larger tumour cell masses via a complex branching network, In additio n, direct continuity was demonstrated between malignant glands within the perineural space and those within the surrounding stromal tissue, During growth, the tumour appeared to have followed the plane of least resistance, although the availability of the perineural space may its elf have been shaped by pressure effects and/or proteolytic enzyme sec retion, Three-dimensional reconstruction of perineural invasion in ade nocarcinoma of the extrahepatic bile ducts shows the value of this tec hnique in demonstrating the structural relationships between the tumou r and the host nerve bundle.