PATHOLOGICAL AND IMMUNOHISTOCHEMICAL FINDINGS IN A CASE OF MUCINOUS CHOLANGIOCARCINOMA

A case of mucinous cholangiocarcinoma is reported, The patient was a 4 9 year old woman with the complaint of lumbago. Imaging examination di sclosed a tumor 3.5 cm in diameter in the right hepatic lobe, which sh owed low density on computerized tomography scans and low signal inten sity on T1-weighted magnetic resonance imaging (MRI) and high intensit y on T2-weighted MRI, The hepatic tumor expanded rapidly and multiple pulmonary metastases and peritoneal dissemination developed, The patie nt died due to respiratory failure 5 months after the initial symptom. An autopsy, a massive tumor (9.5 cm in diameter) containing abundant mucus with several surrounding daughter nodules was found in the right hepatic lobe, Metastases were widespread, Histologically, the tumor w as composed mainly of numerous lobulated mucus lakes in which adenocar cinoma cells floated, Admired signet ring cells were also noted, These gross and histologic features differ from those in other mucin-produc ing hepatic tumors such as biliary papillomatosis and mucinous cystoad enocarcinoma. Immunohistochemically, the adenocarcinoma cells were str ongly positive for carcinoembryonic antigen, Lewis Y, Tn, and T antige ns, and moderately positive for carbohydrate antigen 19-9, Lewis X, si alyl-lewis X and sialyl-Tn antigen. Mature MUC1 mucin and core protein of MUC1 mucin were also expressed to varying degrees, The rapidly exp anding, widespread metastases and poor prognosis found in the present case may be the clinicopathological features of mucinous cholangiocarc inoma.