Intrabiliary growth of metastatic colonic adenocarcinoma: A pattern of intrahepatic spread easily confused with primary neoplasia of the biliary tract Journal Article
| Authors: | Riopel, M. A.; Klimstra, D. S.; Godellas, C. V.; Blumgart, L. H.; Westra, W. H. |
| Article Title: | Intrabiliary growth of metastatic colonic adenocarcinoma: A pattern of intrahepatic spread easily confused with primary neoplasia of the biliary tract |
| Abstract: | 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 intra-hepatic 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. |
| Keywords: | adult; clinical article; human tissue; aged; middle aged; liver neoplasms; adenocarcinoma; metastasis; colonic neoplasms; papillomatosis; cell transformation, neoplastic; liver metastasis; liver; lung carcinoma; bile duct carcinoma; bile duct neoplasms; bile ducts, intrahepatic; epithelium; bladder carcinoma; colon adenocarcinoma; colon; dysplasia; cholangiopancreatography, endoscopic retrograde; liver metastases; bile duct tumor; humans; human; article; colonic adenocarcinoma; biliary dysplasia; biliary papillomatosis; intrabiliary growth |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 21 |
| Issue: | 9 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 1997-09-01 |
| Start Page: | 1030 |
| End Page: | 1036 |
| Language: | English |
| DOI: | 10.1097/00000478-199709000-00007 |
| PUBMED: | 9298879 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 17 March 2017 -- Source: Scopus |
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