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intrahepatic cholangiocarcinoma

Thursday 22 September 2022



Definition : Intrahepatic cholangiocarcinoma (iCCA) is a malignant intrahepatic epithelial neoplasm with biliary differentiation, arising in the liver periphery / proximal to the left and right hepatic ducts (WHO 2019)

Microscopical synopsis

- iCCA consists of infiltrating well formed or cribriform glands in an abundant fibrous stroma (Liver Int 2019;39:7, Surg Pathol Clin 2018;11:403)
- Malignant glands are lined by cells with varying degrees of atypia and pleomorphism (Liver Int 2019;39:7)
- Usually well differentiated adenocarcinoma with mild atypia, intracytoplasmic lumina and intraluminal cellular debris; however, focal atypia with marked pleomorphism can also be present (Liver Int 2019;39:7)
- Commonly infiltrates between hepatic parenchymal cords at the periphery of the tumor
- Multicentricity and perineural invasion are common


Histologic variants include :
- Small duct type iCCA
- Large duct type iCCA
- mucinous,
- signet ring cell,
- clear cell,
- lymphoepithelioma-like,
- thyroid follicular-like,
- adenosquamous
- sarcomatoid