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Pathologic Basis and Classification of Biliary Epithelial Neoplasms

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Diagnosis and Management of Cholangiocarcinoma

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Abstract

Bile duct epithelial neoplasms comprise a heterogeneous group with inconsistencies in classification and nomenclature. These neoplasms may arise anywhere in the biliary system, from canals of Hering to the ampulla of Vater, periductal glands, or gallbladder. Advancements in genetic, epigenetic, and molecular studies have explored and identified individual characteristics of this heterogeneous group and contributed to the current World Health Organization histological classification. Intraluminal malignant neoplastic precursors are generally divided into mass-forming “papillary neoplasms” and non-mass-forming “intraepithelial neoplasia.” Pathological classification of invasive epithelial neoplasms is based on location, histologic features, and genetic characteristics. In this chapter, we outline the spectrum and pathologic basis of biliary epithelial malignancies, malignant precursor lesions, and benign mimics of intrahepatic cholangiocarcinoma, including a brief review of neuroendocrine neoplasms.

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Abbreviations

AC:

Adenocarcinoma

AJCC:

American Joint Committee on Cancer

ASC:

Adenosquamous carcinoma

BAF:

Biliary adenofibroma

BilIN:

Biliary intraepithelial neoplasm

C:

Combined

CA 19-9:

Carbohydrate antigen 19-9

CA:

Carcinoma

CC:

Clear cell

CD:

Cluster of differentiation

CEA:

Carcinoembryonic antigen

c-HCC-CCA:

Combined hepatocellular-cholangiocarcinoma

CK:

Cytokeratin

D:

Distal

DPM:

Ductal plate malformation

EHBD:

Extrahepatic bile duct

EMA:

Epithelial membrane antigen

FISH:

Fluorescent in situ hybridization

GB:

Gallbladder

HCC:

Hepatocellular carcinoma

HCV:

Hepatitis C virus

IC:

Infiltrative class

iCAA:

Intrahepatic cholangiocarcinoma

ICD-O:

International Classification of Diseases for Oncology

ICPN:

Intracholecystic papillary neoplasm

IHC:

Immunohistochemical staining

IPNB:

Intraductal papillary neoplasm of the bile duct

ISH:

In situ hybridization

ITPNB:

Intraductal tubulopapillary neoplasm of the bile duct

LD:

Large duct

MANEC:

Mixed adenoneuroendocrine carcinoma

MCN:

Mucinous cystic neoplasm

MEN:

Multiple neuroendocrine neoplasia

MiNEN:

Mixed neuroendocrine-non-neuroendocrine neoplasm

MUC:

Mucin

NEC:

Neuroendocrine carcinoma

NEN:

Neuroendocrine neoplasm

NES:

Neuron-specific enolase

NET:

Neuroendocrine tumor

P:

Peripheral

PanIn:

Pancreatic intraepithelial neoplasm

PC:

Proliferative class

PGA-GB:

Pyloric gland adenoma of the gallbladder

PSC:

Primary sclerosing cholangitis

SCC:

Squamous cell carcinoma

SC-GB:

Sarcomatoid carcinoma of the gallbladder

SD:

Small duct

VHL:

Von Hippel-Lindau

VMC:

von Meyenburg complex

WHO:

World Health Organization

ZE:

Zollinger-Ellison

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Authors and Affiliations

  1. Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Olive View-UCLA Medical Center, Sylmar, CA, USA

    Payman Fathizadeh & Robin L. Dietz Jr

  2. Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Ronald Reagan UCLA Medical Center, Los Angeles, CA, USA

    Hanlin L. Wang

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    James H. Tabibian

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Fathizadeh, P., Wang, H.L., Dietz, R.L. (2021). Pathologic Basis and Classification of Biliary Epithelial Neoplasms. In: Tabibian, J.H. (eds) Diagnosis and Management of Cholangiocarcinoma. Springer, Cham. https://doi.org/10.1007/978-3-030-70936-5_4

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