INTRAHEPATIC CHOLANGIOCARCINOMAS ASSOCIATED WITH NONBILIARY CIRRHOSIS- A CLINICOPATHOLOGICAL STUDY

To determine the prevalence and clinicopathologic features of cholangi ocarcinoma (CC) associated with nonbiliary cirrhosis, we performed a c linicopathologic study. Among the 5,563 autopsies in our laboratories during the past 14 years, 85 (1.5%) were CCs. Four (4.7%) were associa ted with cirrhosis, due to hepatitis B virus in one case and cryptogen ic (probably non-A non-B hepatitis virus) in the remaining three. Clin ically, patients with CC and cirrhosis were characterized by male prep onderance, lower age, past history of liver injury, and elevated value s of zinc sulfate and thymol turbidity tests. Pathologically, all CCs with cirrhosis were basically adenocarcinoma; other histologic feature s included adenocarcinoma resembling bile ductules without mucin (one case), adenocarcinoma with broad areas of signet ring cell carcinoma ( one case), adenocarcinoma with extensive sarcomatoid transformation (o ne case), and adenocarcinoma associated with hepatoliths (one case). I mmunohistochemically, immunophenotypes of carcinoma cells of CC with c irrhosis were not different from those of CC without cirrhosis. Carcin oembryonic antigens, CA19-9, DU-PAN-2, and biliary-type cytokeratins w ere positive and alpha-fetoprotein was negative, suggesting that our C Cs are not hepatocellular neoplasms but true CCs. It must be stressed that there are actual CCs arising in nonbiliary cirrhotic livers.