[Intrahepatic cholangiocarcinoma: proposal of new macroscopic classification]

From the analysis of 19 resected intrahepatic cholangiocarcinoma (ICC) from 1980 to 1991 in the National Cancer Center Hospital, we classified them into three subcategories, mass-forming ICC, infiltrating ICC and papillary ICC, according to the morphologic pattern. Mass-forming ICC, which made an apparent mass lesion in the liver, showed a spread based on the intrahepatic metastasis with a frequent remnant hepatic recurrence. Infiltrating ICC caused a stricture or an obstruction of intrahepatic bile duct with a spread along the Glisson's capsule without forming a mass in the liver and yielded no remnant liver recurrence except for a local recurrence in the patient with positive surgical margin. Intraductal papillary ICC, which appeared a special type of ICC, developed a papillary projection into the ductal lumen. Three patients of mass-forming ICC and one of papillary ICC survived more than 5 years. The different biologic behaviour should be considered when formulating an operative procedure for each type of ICC.