Pathological aspects of cholangiocarcinoma

Tissue specimens resected from liver and bile-ducts were examined in an attempt to distinguish features of cholangiocarcinoma from those of other tumours and from reactions to duct obstruction and changes in the tumour-bearing liver. Macroscopical and microscopical features were compared and certain changes were found only in cases of cholangiocarcinoma. The type of tumour correlated moderately well with the level of bile duct involved and some microscopical findings were noted only in patients suffering from cholangiocarcinoma. Mucin was demonstrable in all 33 cholangiocarcinomas. Other striking features included heterogeneity of epithelial cells within the same acinus and a tendency to spread between hepatocyte plates, along duct walls and in relation to nerves. Reactive hyperplasia of ductal subepithelial mucous glands was found in association with duct obstruction with and without cholangiocarcinoma. Sclerosis, a common accompaniment of cholangiocarcinoma was noted in other tumours.