Relationship of intrahepatic bile duct hyperplasia to cholangiocellular carcinoma

To investigate the relationship between intrahepatic bile duct hyperplasia and cholangiocellular carcinoma, 27 patients with cholangiocellular carcinoma (including biliary cystadenocarcinoma) and 303 controls were histologically examined. Livers with cholangiocellular carcinoma were closely associated with hyperplasia (100%), atypical hyperplasia (77.8%), and carcinoma in situ (51.9%). Transition from hyperplasia to atypical hyperplasia, and from atypical hyperplasia to carcinoma, was often observed. In the controls, hyperplasia was frequent in those older than 30 years of age, whereas carcinoma was frequent in patients from 50 to 80 years of age. Of the intrahepatic bile ducts examined, the large duct showed the highest incidence of hyperplasia, atypical hyperplasia, and carcinoma in situ. All 27 cases of cholangiocellular carcinoma originated in, or near, the hilus of the liver. These findings suggest that cholangiocellular carcinoma frequently develops from bile duct hyperplasia.