Carcinoma of the extrahepatic biliary tract: a clinicopathological and immunohistochemical study

The clinical and histological findings in 15 cases of carcinoma arising from the extrahepatic biliary tract are reviewed. The clinical findings are in agreement with previously reported series and the dismal prognosis is confirmed. The prognosis does not appear to be related to tumour size, site, mitotic count or laboratory data on presentation. Only histological grading of the tumour is related to prognosis. Perineural tumour infiltration was a prominent feature and dysplasia within adjacent bile duct epithelium was present in five cases. The value of carcinoembryonic antigen (CEA) as a histological tumour marker was investigated. All tumours from the upper and middle biliary tree expressed this antigen. Although immunocytochemistry is seldom needed to assess malignancy in large surgical resection specimens anti-CEA helps delineate the extent of tumour infiltration and discriminates between normal and dysplastic or malignant epithelium; anti-CEA may also be helpful in identifying foci of malignancy in small sclerotic biopsy specimens.