| Intrabiliary growth of metastatic colonic adenocarcinoma: a pattern of intrahepatic spread easily confused with primary neoplasia of the biliary tract. | |
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MedLine Citation:
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PMID: 9298879 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Because of its propensity to spread along epithelial surfaces, colonic adenocarcinoma can mimic other neoplasms. For example, colonic adenocarcinoma can grow along the surface of the urinary bladder and can simulate primary bladder neoplasia, and metastatic colonic adenocarcinoma can grow along alveolar walls and can mimic primary lung neoplasia. Intraepithelial spread along bile ducts, however, is not a well-recognized behavior of hepatic metastases. Indeed, dysplastic change in the epithelium lining the biliary tract is sometimes used to discriminate primary biliary neoplasms from metastatic adenocarcinoma. We report on eight cases of colonic adenocarcinoma metastatic to the liver that demonstrated prominent spread throughout the biliary tree along intact basement membranes. Morphologically, this pattern closely resembled high-grade dysplasia (i.e., carcinoma in situ) of the extrahepatic and intrahepatic bile ducts. Clinically, two of the tumors were mistaken for primary biliary neoplasia because of the common radiologic finding of intrabiliary masses with distended bile ducts. A definite diagnosis of metastatic carcinoma was established by careful attention to the medical history, thorough evaluation of the morphologic features, and histologic comparison with the primary colon cancer. For patients with a history of colonic adenocarcinoma, consideration of a liver metastasis is appropriate even when certain histologic and radiographic features point to a neoplasm of biliary origin. |
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Authors:
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M A Riopel; D S Klimstra; C V Godellas; L H Blumgart; W H Westra |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of surgical pathology Volume: 21 ISSN: 0147-5185 ISO Abbreviation: Am. J. Surg. Pathol. Publication Date: 1997 Sep |
Date Detail:
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Created Date: 1997-10-06 Completed Date: 1997-10-06 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7707904 Medline TA: Am J Surg Pathol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1030-6 Citation Subset: IM |
Affiliation:
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Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-6417, U.S.A. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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diagnosis,
pathology*,
secondary,
surgery Aged Bile Duct Neoplasms / diagnosis, pathology, secondary* Bile Ducts, Intrahepatic / pathology, radiography Cell Transformation, Neoplastic / pathology* Cholangiopancreatography, Endoscopic Retrograde Colon / pathology, radiography Colonic Neoplasms / diagnosis, pathology*, surgery Epithelium / pathology Humans Liver / pathology, radiography Liver Neoplasms / pathology, secondary* Middle Aged |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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