Pathology of cholangiocarcinoma
Pathology of cholangiocarcinoma
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DOI：
10.1007/s00261-004-0187-2
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发表时间：
2004-09-01
影响因子：
--
通讯作者：
Park, CK
中科院分区：
文献类型：
--
作者：
Lim, JH;Park, CK
使用不同术语的不同分类已用于描述肝内和肝外胆管癌的总体外观和放射学结果。 Eggel [1] 将肝内胆管癌分为结节性、块状和弥漫性。 Rosai [2] 将肝外胆管癌分为结节性、硬化性和息肉样三种类型。 Weinbren 和 Mutum [3] 将其分为结节性、硬化性和乳头状。在放射学文献中，肝门部和肝外胆管癌被分类为外生性、浸润性、息肉样或乳头状[4-6]。术语硬化性和浸润性指的是同一类型。然而，结节状、块状、外生性、息肉状、乳头状等术语含糊不清，令人困惑。日本肝癌研究组根据肝内胆管癌的生长特点，提出了肝内胆管癌的新分类：肿块型、导管周围浸润型和导管内生长型等[7]。根据这一新分类，肝外胆管癌的结节型或外生型与肿块型相匹配，浸润型或硬化型与导管周围浸润型相匹配，息肉状或乳头状型与导管内生长型相匹配[8]。日本胆道外科学会提出，肝外胆管癌分为乳头状扩张型、乳头状浸润型、结节状扩张型、结节状浸润型、扁平扩张型、扁平浸润型六种类型[9]。然而，这种分类是多余的，因为它可以进一步简化。 Klatskin [10] 认识到剖腹手术中看到的三种主要类型的肝门部胆管癌：小纤维结节、节段性狭窄和乳头状生长。在其他分类中，肝外胆管癌根据宏观外观分为结节性、硬化性和乳头状[3, 11]。这些分类是基于总体形态
Different classifications using various terminologies have been used to describe the gross appearances and radiologic findings of intra-and extrahepatic cholangiocarcinomas. Eggel [1] classified intrahepatic cholangiocarcinomas as nodular, massive, and diffuse. Rosai [2] classified extrahepatic cholangiocarcinomas into three types: nodular, sclerosing, and polypoid. Weinbren and Mutum [3] classified these as nodular, sclerosing, and papillary. In the radiologic literature, hilar and extrahepatic cholangiocarcinomas are classified as exophytic, infiltrating, and polypoid or papillary [4–6]. The terms sclerosing and infiltrative refer to the same type. However, terminologies such as nodular, massive, exophytic, polypoid, and papillary are ambiguous and confusing.The Liver Cancer Study Group of Japan has proposed a new classification for intrahepatic cholangiocarcinoma as mass-forming, periductal-infiltrating, and intraductal-growing based on their growth characteristics [7]. According to this new classification, the nodular or exophytic type of extrahepatic cholangiocarcinomas matches the mass-forming type, the infiltrating or sclerosing type matches the periductal-infiltrating type, and the polypoid or papillary type matches the intraductal-growing type [8]. The Japanese Society of Biliary Surgery has proposed that extrahepatic cholangiocarcinoma be classified into six types: papillary-expanding, papillary-infiltrating, nodularexpanding, nodular-infiltrating, flat-expanding, and flat-infiltrating [9]. However, this classification is redundant because it can be simplified further. Klatskin [10] recognized three main types of hilar cholangiocarcinoma as seen on laparotomy: a small fibrous nodule, a segmental stenosis, and a papillary growth. In other classifications, extrahepatic cholangiocarcinomas have been categorized as nodular, sclerosing, and papillary by macroscopic appearance [3, 11]. These classifications are based on the gross morphology of