An S100P-positive biliary epithelial field is a pre-invasive intraepithelial neoplasm in nodular-sclerosing cholangiocarcinoma

Nodular sclerosing cholangiocarcinoma (NS-CCA) is a common CCA of the intrahepatic large, perihilar and distal bile ducts. Intraepithelial biliary neoplasms, such as the mucosal extension of carcinoma and pre-invasive neoplastic lesions (i.e. biliary intraepithelial neoplasia [BilIN]) reportedly occ...

Full description

Saved in:
Bibliographic Details
Published in:Human pathology 2016
Main Authors: Nakanuma, Yasuni, MD, Uchida, Tsuneyuki, MD, Sato, Yasunori, MD, Uesaka, Katsuhiko, MD
Format: Article
Language:English
Subjects:
Pathology
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Nodular sclerosing cholangiocarcinoma (NS-CCA) is a common CCA of the intrahepatic large, perihilar and distal bile ducts. Intraepithelial biliary neoplasms, such as the mucosal extension of carcinoma and pre-invasive neoplastic lesions (i.e. biliary intraepithelial neoplasia [BilIN]) reportedly occur in the bile ducts around CCA. In the present study, we collectively refer to these intraepithelial lesions as “intraepithelial neoplasms of the bile duct (IENBs)”. We examined the IENBs in 57 surgically resected cases of NS-CCA. S100P immunostaining was used to help detect IENBs. The IENBs formed field(s) of continuous neoplastic biliary epithelial cells and showed a flat, micropapillary, or papillotubular configuration. IENBs could be classified into three categories based on their atypia: Group A (neoplastic but not enough for malignancy), B (neoplastic and sufficiently well differentiated for high-grade dysplasia), and C (overtly malignant and variably differentiated). IENB was found in 31 of 57 cases, with Group C the most common (26 cases) followed by Group B (22 cases) and Group A (16 cases). The expression of cancer-related molecules and MIB-1 index of Groups A and B differed from those of invasive CCA, while these features of Group C were relatively similar to those of invasive CCA. In conclusion, IENB was not infrequently found in NS-CCA and could be classified into three grades. Pre-invasive lesions (BilINs) are likely to be found in Groups A and B, whereas cancerization would be included in Group C. The classification of IENB may be useful for future studies of the pre-invasive intraepithelial neoplastic lesions of NS-CCAs.
ISSN:0046-8177
1532-8392
DOI:10.1016/j.humpath.2016.10.003