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intrahepatic cholangiocarcinoma
Thursday 22 September 2022
iCCA
| PO |
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
Variants
Histologic variants include :
Small duct type iCCA
Large duct type iCCA
mucinous,
signet ring cell,
clear cell,
lymphoepithelioma-like,
thyroid follicular-like,
adenosquamous
sarcomatoid