Department of Surgical Oncology, Division of Surgery, Hokkaido University Graduate School of Medicine, N-15, W-17, Sapporo, 060-0815, Japan.
Surg Today. 2011 Dec;41(12):1674-9. doi: 10.1007/s00595-011-4508-0. Epub 2011 Oct 4.
Extensive intraepithelial spread of bile duct carcinoma is a common feature, seen in approximately 18% of all cases. However, this spread is rarely accompanied by bile duct strictures. We herein describe three cases of bile duct carcinoma with multiple bile duct strictures due to extensive intraepithelial spread. In all three cases, the spread of intraepithelial cancer extended into the epithelium of the peribiliary glands along the intrahepatic bile ducts with marked fibrosis on histopathological examination. It is speculated that peribiliary gland involvement by superficially spreading bile duct cancer and subsequent obstructive glandular inflammation with fibrosis might cause intrahepatic bile duct strictures even without interstitial cancer invasion.
胆管癌的广泛上皮内扩散是一种常见特征，约见于所有病例的 18%。然而，这种扩散很少伴有胆管狭窄。本文描述了 3 例因广泛上皮内扩散而导致多个胆管狭窄的胆管癌病例。在所有 3 例中，上皮内癌的扩散沿着肝内胆管延伸至胆管周围腺体的上皮，组织病理学检查显示明显纤维化。据推测，浅表扩散性胆管癌累及胆管周围腺体，并随后发生阻塞性腺体炎症伴纤维化，即使没有间质癌浸润，也可能导致肝内胆管狭窄。
