cpc1 pathology answer

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Gross autopsy findings . Jaundice of skin and scleraHepatomegaly Cirrhosis Irregular hepatic mass 7 x 7 x 6.8 cm Satellite nodules throughout liver parenchyma and on surfaceNodules in peripancreatic lymph nodes and perihilar lymph nodes of lung. LIVER. LUNG. LUNG. CYTOKERATIN. Carcinomas of the Liver.

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1. CPC#1 Pathology Answer Erin Carney, MD Srivatsan Raghavan, MSIV Pedram Argani, MD

9. Carcinomas of the Liver Metastatic Primary Hepatocyte (Hepatocellular Carcinoma) Bile Duct (Cholangiocarcinoma)

13. Immunohistochemistry Hepatocellular Carcinoma HePar-1+ CK7- Cholangiocarcinoma HePar-1- CK7+

14. Our Case Positive CK7 Negative Hepar-1

15. Diagnosis Intrahepatic Cholangiocarcinoma

18. Diagnoses Intrahepatic Cholangiocarcinoma with metastases to liver, right and left lungs, abdominal and thoracic lymph nodes, duodenum Cirrhosis of Liver Mild Alzeimer type II astrocytosis in brain consistent with hepatic encephalopathy Atherosclerosis, coronary and cerebral arteries, aorta

19. Cholangiocarcinoma 10-20% of primary liver cancers 5000 cases/year in USA, incidence increasing 42% multicentric Differential diagnosis is metastatic adenocarcinoma

20. Cholangiocarcinoma: Risk Factors Primary Sclerosing Cholangitis Hepatobilary Flukes Opisthorchis vivverini Clonorchis Sinensis Recurrent Bacterial Cholangitis Chronic Hepatitis C Alcoholic Cirrhosis

23. Cholangiocarcinoma Prognosis Poor Resectability is key prognostic factor Median Survival Resectable: 30 months Unresectable: 6 months

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