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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