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Intrabiliary growth of metastatic colonic adenocarcinoma: a pattern of intrahepatic spread easily confused with primary neoplasia of the biliary tract.
- Source :
-
The American journal of surgical pathology [Am J Surg Pathol] 1997 Sep; Vol. 21 (9), pp. 1030-6. - Publication Year :
- 1997
-
Abstract
- Because of its propensity to spread along epithelial surfaces, colonic adenocarcinoma can mimic other neoplasms. For example, colonic adenocarcinoma can grow along the surface of the urinary bladder and can simulate primary bladder neoplasia, and metastatic colonic adenocarcinoma can grow along alveolar walls and can mimic primary lung neoplasia. Intraepithelial spread along bile ducts, however, is not a well-recognized behavior of hepatic metastases. Indeed, dysplastic change in the epithelium lining the biliary tract is sometimes used to discriminate primary biliary neoplasms from metastatic adenocarcinoma. We report on eight cases of colonic adenocarcinoma metastatic to the liver that demonstrated prominent spread throughout the biliary tree along intact basement membranes. Morphologically, this pattern closely resembled high-grade dysplasia (i.e., carcinoma in situ) of the extrahepatic and intrahepatic bile ducts. Clinically, two of the tumors were mistaken for primary biliary neoplasia because of the common radiologic finding of intrabiliary masses with distended bile ducts. A definite diagnosis of metastatic carcinoma was established by careful attention to the medical history, thorough evaluation of the morphologic features, and histologic comparison with the primary colon cancer. For patients with a history of colonic adenocarcinoma, consideration of a liver metastasis is appropriate even when certain histologic and radiographic features point to a neoplasm of biliary origin.
- Subjects :
- Adenocarcinoma diagnosis
Adenocarcinoma secondary
Adenocarcinoma surgery
Aged
Bile Duct Neoplasms diagnosis
Bile Duct Neoplasms pathology
Bile Ducts, Intrahepatic diagnostic imaging
Bile Ducts, Intrahepatic pathology
Cholangiopancreatography, Endoscopic Retrograde
Colon diagnostic imaging
Colon pathology
Colonic Neoplasms diagnosis
Colonic Neoplasms surgery
Epithelium pathology
Humans
Liver diagnostic imaging
Liver pathology
Liver Neoplasms pathology
Middle Aged
Adenocarcinoma pathology
Bile Duct Neoplasms secondary
Cell Transformation, Neoplastic pathology
Colonic Neoplasms pathology
Liver Neoplasms secondary
Subjects
Details
- Language :
- English
- ISSN :
- 0147-5185
- Volume :
- 21
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- The American journal of surgical pathology
- Publication Type :
- Academic Journal
- Accession number :
- 9298879
- Full Text :
- https://doi.org/10.1097/00000478-199709000-00007