Clinical and Molecular Hepatology

"Cholangiocarcinoma"

Original Articles

Inactivating LATS2 Variation Drives Tumor Progression and Resistance to Anti-PD-1 Therapy in Intrahepatic Cholangiocarcinoma: Ye Xu, Kai-Xuan Liu, Xin-Yu Wang, Shuang-Yi Chen, Yu-Hang Ye, Ning Li, Fan Weng, Long Chen, Cun-Yang Tu, Zi-Han Tian, Chu-Bin Luo, Zhi-Qiang Hu, Zheng-Jun Zhou, Jia Fan, Jian Zhou, Shao-Lai Zhou; Received September 11, 2025 Accepted March 10, 2026 Published online March 18, 2026; DOI: https://doi.org/10.3350/cmh.2025.0997 [Accepted]

Abstract
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Background
/ Aims: Recurrence is a major factor limiting the long-term survival of patients with intrahepatic cholangiocarcinoma (ICC). The molecular characteristics and potential therapeutic targets in ICC remain largely undefined.
Methods
Following our previous whole-exome sequencing study, we performed targeted sequencing, Sanger sequencing, and quantitative PCR to assess all coding exons and copy number variations of LATS2 in 400 primary ICC samples. Kaplan–Meier survival curves were used to assess the impact of LATS2 mutation, copy number loss, and low expression levels on recurrence-free survival and overall survival in ICC patients. In addition, we investigated the functional role and underlying mechanisms of LATS2 variation in ICC tumor progression and resistance to anti-PD1 therapy.
Results
Among a total of 400 ICC cases, the overall frequencies of LATS2 somatic mutation and copy number loss were 3% (12/400) and 34% (136/400), respectively. Both types of variation were correlated with decreased LATS2 protein expression, increased tumor recurrence, and poor overall survival. Biofunctional investigations revealed a tumor-suppressor role of LATS2. Inactivation of LATS2 suppressed the Hippo signaling pathway, leading to aberrant activation of YAP, which upregulated PD-L1 expression and CCL2 secretion, suppressed CD8+ T cell infiltration, and enhanced recruitment of M2-like macrophages, thereby promoting immune evasion, tumor progression, and resistance to anti-PD-1 therapy.
Conclusions
Our study reveals a pivotal clinical association and mechanistic role of LATS2-inactivating variation in ICC, which may serve as a useful biomarker for precision therapy.

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PRMT1-mediated asymmetric dimethylation of arginine residue 602 in DDX1 promotes cholangiocarcinoma progression: Wenzheng Liu, Yangwei Liao, Yiyang Kuai, Xin Gao, Xingmin Yan, Jingjing Li, Junsheng Chen, Jukun Su, Jingcong Zhou, Yizhu Kong, Siqin Huang, Zhiwei Zhang, Feng Peng, Bing Wang, Yongjun Chen; Clin Mol Hepatol 2026;32(2):843-865.
Published online February 11, 2026; DOI: https://doi.org/10.3350/cmh.2025.1252

Background/Aims
Cholangiocarcinoma (CCA) is a primary malignant neoplasm with an extremely poor prognosis. While combined chemoradiotherapy has been demonstrated to delay CCA progression to a certain extent, the absence of specific molecular biomarkers or targets significantly hinders the diagnosis and treatment of CCA.
Methods
Through cross-analysis of proteomics and ADMA modificationomics, we identified DDX1 overexpressed in CCA with elevated R602-ADMA modifications. HPLC-MS/MS identified PRMT1 as the methyltransferase and USP10 as the deubiquitinating enzyme for DDX1. Immunofluorescence and nuclear-cytoplasmic partitioning experiments confirmed DDX1’s nuclear localization. GO and KEGG analyses clarify the biological functions of DDX1 in response to hypoxia. RNA-seq transcriptomics analyzed key pathways influenced by DDX1. A hydrodynamic in situ CCA mouse model was established to validate the chemopreventive effects of the PRMT1-specific inhibitor GSK715 on CCA development.
Results
DDX1 promotes CCA progression both in vivo and in vitro and can be inhibited by GSK715. Mechanistically, PRMT1 mediates ADMA modification at position R602 of DDX1. This modification promotes DDX1 nuclear localization by recruiting USP10 to deubiquitinate DDX1, while simultaneously inhibiting PRMT1 degradation. DDX1 promotes the transcription of PRMT1 and USP10 by binding to the mRNA 3’UTR region, establishing a positive feedback regulatory pathway. This mechanism promotes the occurrence and development of CCA and can serve as a target for the inhibitor GSK715 to suppress CCA progression.
Conclusions
Our study identified DDX1-R602-ADMA modification as a novel ADMA modification in CCA. It further confirmed its pivotal role in CCA progression. Targeting the USP10-PRMT1-DDX1 axis may represent a significant therapeutic approach for CCA.

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Review

Stratifying cholangiocarcinoma: tumor microenvironment, molecular drivers, and novel immunotherapeutic approaches: Cindy Xinqi Liu, Carmen Chak-Lui Wong; Clin Mol Hepatol 2026;32(1):127-155.
Published online October 14, 2025; DOI: https://doi.org/10.3350/cmh.2025.0889

Abstract
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Cholangiocarcinoma (CCA) is an epithelial cell cancer of the biliary tract. CCA can be further classified into intrahepatic cholangiocarcinoma (iCCA), perihilar cholangiocarcinoma (pCCA), and distal cholangiocarcinoma (dCCA) depending on the anatomical location. Until recently, the treatment for advanced CCA has remained highly reliant on chemotherapy, with gemcitabine plus cisplatin used in first-line treatment. Recent developments have led to the addition of immune checkpoint blockade (ICB) to the chemotherapy regimen, highlighting the promising potential of immunotherapies for CCA treatment. Despite these developments, most patients still do not benefit from current treatments, and response rates to ICB monotherapy remain modest. This underscores the need to develop more effective immunotherapeutic strategies. A major obstacle to this is the highly heterogenous nature of the disease. CCA tumors exhibit high inter-tumor heterogeneity in terms of anatomical locations, driver mutations, etiologies, and tumor microenvironment (TME) composition, making each patient immunologically distinct and difficult to benefit from a one-size-fits-all approach. There is a need to stratify patients according to individual disease status to identify immunotherapies and combination therapies that are most beneficial to them. Here we describe the different ways inter-tumor heterogeneity may arise in CCA, including stromal cell abundance, anatomical location, driver mutations, etiologies, TME profile, and tertiary lymphoid structure (TLS) presence. We also discuss what these factors mean to the immune microenvironment and their potential to be used as biomarkers. Careful stratification of patients is crucial in designing personalized medicine to improve survival outcomes and treatment efficacy for CCA patients.

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Integrative single-cell and machine-learning analysis identifies ac4C-related S100A13 as a causal risk gene in cholangiocarcinoma
Yi Zheng, Yan Lin, Zilin Wang, Fazong Wu
BMC Cancer.2026;[Epub] CrossRef
Development of a prediction model integrating cardiac ultrasound parameters for cardiac complications after distal cholangiocarcinoma surgery: a retrospective cohort study
Fangfei Wang, Shan Jin, Shaocheng Lyu, Xin Zhao, Xiuzhang Lyu, Qiang He
BMC Medical Imaging.2026;[Epub] CrossRef
Combined Model of Inflammatory-Nutritional Indicators and Tumor Markers for Predicting Prognosis in Patients with Distal Cholangiocarcinoma: A Retrospective Cohort Study
Fangfei Wang, Jinhao Li, Xin Zhao, Shaocheng Lyu, Qiang He
Diseases.2026; 14(3): 97. CrossRef

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Letter to the Editor

Letter to the editor on “Radiogenomics of intrahepatic cholangiocarcinoma predicts immunochemotherapy response and identifies therapeutic target”: Yuqian Liu, Ruiyun Guo, Jun Ma; Clin Mol Hepatol 2026;32(1):e13-e15.
Published online April 23, 2025; DOI: https://doi.org/10.3350/cmh.2025.0377

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Original Article

Radiogenomics of intrahepatic cholangiocarcinoma predicts immunochemotherapy response and identifies therapeutic target: Gu-Wei Ji, Zheng-Gang Xu, Shuo-Chen Liu, Shu-Ya Cao, Chen-Yu Jiao, Ming Lu, Biao Zhang, Yue Yang, Qing Xu, Xiao-Feng Wu, Ke Wang, Yong-Xiang Xia, Xiang-Cheng Li, Xue-Hao Wang; Clin Mol Hepatol 2025;31(3):935-959.
Published online February 10, 2025; DOI: https://doi.org/10.3350/cmh.2024.0895

Background/Aims
Identifying patients with intrahepatic cholangiocarcinoma (ICC) likely to benefit from immunochemotherapy, the new front-line treatment, remains challenging. We aimed to unveil a novel radiotranscriptomic signature that can facilitate treatment response prediction by multi-omics integration and multiscale modelling.
Methods
We analyzed bulk, single-cell and spatial transcriptomic data comprising 457 ICC patients to identify an immune-related score (IRS), followed by decoding its spatial immune context. We mapped radiomics profiles onto spatial-specific IRS using machine learning to define a novel radiotranscriptomic signature, followed by multi-scale and multi-cohort validation covering 331 ICC patients. The signature was further explored for the potential therapeutic target from in vitro to in vivo.
Results
We revealed a novel 3-gene (PLAUR, CD40LG, and FGFR4) IRS whose down-regulation correlated with better survival and improved sensitivity to immunochemotherapy. We highlighted functional IRS-immune interactions within tumor epithelium, rather than stromal compartment, irrespective of geospatial locations. Machine learning pipeline identified the optimal 3-feature radiotranscriptomic signature that was well-validated by immunohistochemical assays in molecular cohort, exhibited favorable external prognostic validity with C-index over 0.64 in resection cohort, and predicted treatment response with an area under the curve of up to 0.84 in immunochemotherapy cohort. We also showed that anti-uPAR/PLAUR alone or in combination with anti-programmed cell death protein 1 therapy remarkably curbed tumor growth, using in vitro ICC cell lines and in vivo humanized ICC patient-derived xenograft mouse models.
Conclusions
This proof-of-concept study sheds light on the spatially-resolved radiotranscriptomic signature to improve patient selection for emerging immunochemotherapy and high-order immunotherapy combinations in ICC.

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Yufen Xu, Xiaofang Xu, Yan Xu, Jianwen Duan
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You Chen, Rui Ma, Chuyue Wang, Zhiying Yang, Ying Shi, Yingying Zhao, Xiaofen Pan, Bo Wang, Weili Wu, Ping Yuan
Experimental Cell Research.2026; 455(2): 114850. CrossRef
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How to efficiently establish animal models of cholangiocarcinoma: challenges and inspiration
Ruiqiang Gou, Ping Yue, Peng Liu, Jinyu Zhao, Chunfei Huang, Kiyohito Tanaka, Peng F Wong, Rungsun Rerknimitr, Jong H Moon, Tan T Cheung, Christian Waydhas, Azumi Suzuki, Yanyan Lin, Emmanuel Melloul, Hans Schlitt, John Fung, Joseph W Leung, Wenbo Meng
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Correspondence

Hepatic neoplasm

Correspondence to editorial on “Development and validation of a stromal-immune signature to predict prognosis in intrahepatic cholangiocarcinoma”: Yu-Hang Ye, Shao-Lai Zhou; Clin Mol Hepatol 2025;31(1):e90-e92.
Published online November 11, 2024; DOI: https://doi.org/10.3350/cmh.2024.0998

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Editorial

Hepatic neoplasm

Stroma-tology: Predicting recurrence in cholangiocarcinoma: Editorial on “Development and validation of a stromal-immune signature to predict prognosis in intrahepatic cholangiocarcinoma”: Sergi Marco, Chiara Braconi; Clin Mol Hepatol 2025;31(1):323-326.
Published online October 29, 2024; DOI: https://doi.org/10.3350/cmh.2024.0932

Citations

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Correspondence to editorial on “Development and validation of a stromal-immune signature to predict prognosis in intrahepatic cholangiocarcinoma”
Yu-Hang Ye, Shao-Lai Zhou
Clinical and Molecular Hepatology.2025; 31(1): e90. CrossRef

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Original Articles

Hepatic neoplasm

Development and validation of a stromal-immune signature to predict prognosis in intrahepatic cholangiocarcinoma: Yu-Hang Ye, Hao-Yang Xin, Jia-Li Li, Ning Li, Si-Yuan Pan, Long Chen, Jing-Yue Pan, Zhi-Qiang Hu, Peng-Cheng Wang, Chu-Bin Luo, Rong-Qi Sun, Jia Fan, Jian Zhou, Zheng-Jun Zhou, Shao-Lai Zhou; Clin Mol Hepatol 2024;30(4):914-928.
Published online August 6, 2024; DOI: https://doi.org/10.3350/cmh.2024.0296

Backgrounds/Aims
Intrahepatic cholangiocarcinoma (ICC) is a highly desmoplastic tumor with poor prognosis even after curative resection. We investigated the associations between the composition of the ICC stroma and immune cell infiltration and aimed to develop a stromal-immune signature to predict prognosis in surgically treated ICC.
Methods
We recruited 359 ICC patients and performed immunohistochemistry to detect α-smooth muscle actin (α-SMA), CD3, CD4, CD8, Foxp3, CD68, and CD66b. Aniline was used to stain collagen deposition. Survival analyses were performed to detect prognostic values of these markers. Recursive partitioning for a discrete-time survival tree was applied to define a stromal-immune signature with distinct prognostic value. We delineated an integrated stromal-immune signature based on immune cell subpopulations and stromal composition to distinguish subgroups with different recurrence-free survival (RFS) and overall survival (OS) time.
Results
We defined four major patterns of ICC stroma composition according to the distributions of α-SMA and collagen: dormant (α-SMAlow/collagenhigh), fibrogenic (α-SMAhigh/collagenhigh), inert (α-SMAlow/collagenlow), and fibrolytic (α-SMAhigh/collagenlow). The stroma types were characterized by distinct patterns of infiltration by immune cells. We divided patients into six classes. Class I, characterized by high CD8 expression and dormant stroma, displayed the longest RFS and OS, whereas Class VI, characterized by low CD8 expression and high CD66b expression, displayed the shortest RFS and OS. The integrated stromal-immune signature was consolidated in a validation cohort.
Conclusions
We developed and validated a stromal-immune signature to predict prognosis in surgically treated ICC. These findings provide new insights into the stromal-immune response to ICC.

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Zaiba Shafik Dawood, Mujtaba Khalil, Arsalan Javid, Abdul Ali, Usama Waqar, Zayan Alidina, Illiyun Banani, Timothy M. Pawlik
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Hepatic neoplasm

Burden of mortality from hepatocellular carcinoma and biliary tract cancers by race and ethnicity and sex in US, 2018–2023: Donghee Kim, Richie Manikat, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed; Clin Mol Hepatol 2024;30(4):756-770.
Published online June 24, 2024; DOI: https://doi.org/10.3350/cmh.2024.0318

Backgrounds/Aims
The trends in mortality of hepatocellular carcinoma (HCC) and biliary tract cancers stratified by sex and race/ethnicity in the US continue to evolve. We estimated the sex- and race/ethnicity-based trends in HCC and biliary tract cancers-related mortality in US adults with a focus on disease burden.
Methods
We performed a population-based analysis using the US national mortality records from 2018 to 2023. We identified HCC and biliary tract cancer using appropriate ICD-10 codes. Temporal trends in mortality were calculated by joinpoint analysis with annual percentage change (APC).
Results
Annual age-standardized mortality from HCC decreased steadily with an APC of –1.4% (95% confidence interval [CI]: –2.0% to –0.7%). While there was a linear increase in intrahepatic cholangiocarcinoma-related mortality (APC: 3.1%, 95% CI: 1.2–4.9%) and ampulla of Vater cancer-related mortality (APC: 4.1%, 95% CI: 0.5–7.9%), gallbladder cancer-related mortality decreased (APC: –1.9%, 95% CI: –3.8% to –0.0%). Decreasing trends in mortality from HCC were noted in males, not females. HCC-related mortality decreased more steeply in racial and ethnic minority individuals compared with non-Hispanic White individuals. Racial and ethnic differences in trends in mortality for biliary tract cancers depended on the malignancy’s anatomical site.
Conclusions
While the annual mortality for HCC and gallbladder cancer demonstrated declining trends, ICC- and AVC-related mortality continued to increase from 2018 to 2023. Although racial and ethnic minority individuals in the US experienced disproportionately higher HCC and biliary tract cancer, recent declines in HCC may be primarily due to declines among racial and ethnic minority individuals and males.

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Reviews

Intrahepatic cholangiocarcinoma: Tumour heterogeneity and its clinical relevance: Mina Komuta; Clin Mol Hepatol 2022;28(3):396-407.
Published online January 14, 2022; DOI: https://doi.org/10.3350/cmh.2021.0287

Abstract
PDF

Treatment of intrahepatic cholangiocarcinoma (iCCA) is currently at a significant turning point due to the identification of isocitrate dehydrogenase (IDH) mutations and fibroblast growth factor receptor (FGFR) fusions that can be targeted with currently available therapies. Clinical trials of these targeted therapies have been promising, and the iCCA patients who may benefit from these targeted treatments can be identified by pathological examination prior to molecular investigations. This is because IDH mutations and FGFR fusions are mainly seen in the small duct type iCCA, a subtype of iCCA defined by the 5th World Health Organization classification, which can be recognized by the pathological diagnostic process. Therefore, pathology plays an important role in precision medicine for iCCA, not only in confirming the diagnosis, but also in identifying the iCCA patients who may benefit from targeted treatments. However, caution is advised with the pathological diagnosis, as iCCA shows tumour heterogeneity, making it difficult to distinguish small duct type iCCA from hepatocellular carcinoma (HCC), and combined HCC-CCA. This review focuses on the pathological/molecular features of both subtypes of iCCA (large and small duct types), as well as their diagnostic pitfalls, clinical relevance, and future perspectives.

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Hepatic neoplasm

Radiomics and radiogenomics of primary liver cancers: Woo Kyoung Jeong, Neema Jamshidi, Ely Richard Felker, Steven Satish Raman, David Shinkuo Lu; Clin Mol Hepatol 2019;25(1):21-29.
Published online November 16, 2018; DOI: https://doi.org/10.3350/cmh.2018.1007

Abstract
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Concurrent advancements in imaging and genomic biomarkers have created opportunities to identify non-invasive imaging surrogates of molecular phenotypes. In order to develop such imaging surrogates radiomics and radiogenomics/imaging genomics will be necessary; there has been consistent progress in these fields for primary liver cancers. In this article we evaluate the current status of the field specifically with regards to hepatocellular carcinoma and intrahepatic cholangiocarcinoma, highlighting some of the up and coming results that were presented at the annual Radiological Society of North America Conference in 2017. There are an increasing number of studies in this area with a bias towards quantitative feature measurement, which is expected to benefit reproducibility of the findings and portends well for the future development of biomarkers for diagnosis, prognosis, and treatment response assessment. We review some of the advancements and look forward to some of the exciting future applications that are anticipated as the field develops.

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18,203 View
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Crossref

Liver Pathologys

Hepatic neoplasm

Primary adenosquamous carcinoma of the liver: a case report: Kyung Han Nam, Ji Yeon Kim; Clin Mol Hepatol 2016;22(4):503-508.
Published online December 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0077

Abstract
PDF

Adenosquamous carcinoma of the liver is a rare variant of cholangiocarcinoma. It is known to be a highly aggressive tumor with a poor prognosis, but its pathogenesis remains unclear owing to limited data in the literature. We report a case of 56-year-old woman who presented with a 1-week history of epigastric pain. Magnetic resonance imaging revealed a 6.5-cm ill-defined mass with low signal intensity in the left lobe of the liver, which was suspicious of cholangiocarcinoma. The patient underwent left hemihepatectomy. Microscopically, the tumor consisted of malignant glandular and squamous components and staged as pT2aN1. Despite postoperative chemoradiation, the patient had recurrence 8 months after surgery.

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Quynh Thi Nguyen, Hiep Canh Nguyen, Kenta Takahashi, Kaori Yoshimura, Hiroko Ikeda, Kazuto Kozaka, Zihan Li, Dong Thanh Le, Rui Yang, Shintaro Yagi, Kenichi Harada
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Use of sintilimab in primary adenosquamous carcinoma of the liver results in pathological complete response: a case report and literature review
Zhiqing Bai, Yu-Ann Chen, Ying Xiao, Jianping Song, Jianwei Song, Canhong Xiang
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Quynh Nguyen Thi, Hiep Nguyen Canh, Zihan Li, Khuyen Nguyen Thi, Kaori Yoshimura, Kenta Takahashi, Rui Yang, Dong Le Thanh, Tram Nguyen Thi, Shintaro Yagi, Kenichi Harada
Human Pathology.2025; 160: 105824. CrossRef
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Takuto Nosaka, Masahiro Ohtani, Shouichi Namikawa, Kazuto Takahashi, Tatsushi Naito, Kazuya Ofuji, Hidetaka Matsuda, Katsushi Hiramatsu, Yoshiaki Imamura, Yasunari Nakamoto
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Treatment and Survival Patterns of Primary Adenosquamous Carcinoma of the Liver: A Retrospective Analysis
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Nuh Filizoglu, Kevser Oksuzoglu, Salih Ozguven
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Yusuke Watanabe, Akihiko Osaki, Kiwamu Kimura, Shunta Yakubo, Kenichi Takaku, Munehiro Sato, Hideki Hashidate, Nobuo Waguri, Shuji Terai
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Hong-Shuai Li, Tao He, Li-Li Yang
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CT and MR imaging features of pancreatic adenosquamous carcinoma and their correlation with prognosis
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Abdominal Radiology.2019; 44(8): 2822. CrossRef

12,173 View
129 Download
14 Web of Science
Crossref

Hepatic neoplasm

Histopathology of a benign bile duct lesion in the liver: Morphologic mimicker or precursor of intrahepatic cholangiocarcinoma: Kyoung-Bun Lee; Clin Mol Hepatol 2016;22(3):400-405.
Published online September 25, 2016; DOI: https://doi.org/10.3350/cmh.2016.0105

Abstract
PDF

A bile duct lesion originating from intrahepatic bile ducts is generally regarded as an incidental pathologic finding in liver specimens. However, a recent study on the molecular classification of intrahepatic cholangiocarcinoma has focused on the heterogeneity of this carcinoma and has suggested that the cells of different origins present in the biliary tree may have a major role in the mechanism of oncogenesis. In this review, benign intrahepatic bile duct lesions—regarded in the past as reactive changes or remnant developmental anomalies and now noted to have potential for developing precursor lesions of intrahepatic cholangiocarcinoma—are discussed by focusing on the histopathologic features and its implications in clinical practice.

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Hepatic neoplasm

Sarcomatoid cholangiocarcinoma with osteoclast-like giant cells associated with hepatolithiasis: A case report: Hye Min Kim, Haeryoung Kim, Young Nyun Park; Clin Mol Hepatol 2015;21(3):309-313.
Published online September 30, 2015; DOI: https://doi.org/10.3350/cmh.2015.21.3.309

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Hepatic neoplasm

Cholangiolocellular carcinoma with satellite nodules showing intermediate differentiation: Wonkyung Jung, Baek-hui Kim; Clin Mol Hepatol 2015;21(2):183-186.
Published online June 26, 2015; DOI: https://doi.org/10.3350/cmh.2015.21.2.183

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Osteopenia Is Associated with Shorter Survival in Patients with Intrahepatic Cholangiocarcinoma
Atsushi Miki, Yasunaru Sakuma, Jun Watanabe, Kazuhiro Endo, Hideki Sasanuma, Takumi Teratani, Alan Kawarai Lefor, Joji Kitayama, Naohiro Sata
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5 Web of Science
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Liver Imaging

Hepatic neoplasm

Composite liver tumors: A radiologic-pathologic correlation: Megha Nayyar, David K. Imagawa, Temel Tirkes, Aram N. Demirjian, Roozbeh Houshyar, Kumar Sandrasegaran, Chaitali S. Nangia, Tara Seery, P Bhargava, Joon II Choi, Chandana Lall; Clin Mol Hepatol 2014;20(4):406-410.
Published online December 24, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.4.406

Abstract
PDF

Bi-phenotypic neoplasm refers to tumors derived from a common cancer stem cell with unique capability to differentiate histologically into two distinct tumor types. Bi-phenotypic hepatocellular carcinoma-cholangiocarcinoma (HCC-CC), although a rare tumor, is important for clinicians to recognize, since treatment options targeting both elements of the tumor are crucial. Imaging findings of bi-phenotypic HCC-CC are not specific and include features of both HCC and CC. A combination of imaging and immuno-histochemical analysis is usually needed to make the diagnosis.

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Abdominal Radiology.2017; 42(12): 2909. CrossRef

11,170 View
67 Download
3 Web of Science
Crossref

Liver Pathologys

Hepatic neoplasm

Intrahepatic cholangiocarcinoma arising in Caroli's disease: Min Hye Jang, Yoon Jin Lee, Haeryoung Kim; Clin Mol Hepatol 2014;20(4):402-405.
Published online December 24, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.4.402

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98 Download
16 Web of Science
Crossref

Hepatic neoplasm

Intrahepatic cholangiocarcinoma with predominant ductal plate malformation pattern: Ji-Young Choe, Haeryoung Kim; Clin Mol Hepatol 2014;20(2):214-217.
Published online June 30, 2014; DOI: https://doi.org/10.3350/cmh.2014.20.2.214

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Spectrum of Biliary Lesions/Neoplasms in Hepatic Parenchyma with Reference to a Precursor of Small Duct-Type Intrahepatic Cholangiocarcinoma: Comprehensive Categorization into Three Groups
Yasuni Nakanuma, Motoko Sasaki, Yuko Kakuda, Takuma Oishi
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Hepatic neoplasm

Exophytic combined hepatocellular carcinoma and cholangiocarcinoma: Sang Jae Noh, Hyun Kyung Lee, Hee Chul Yu, Woo Sung Moon; Korean J Hepatol 2012;18(4):416-419.
Published online December 21, 2012; DOI: https://doi.org/10.3350/cmh.2012.18.4.416

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Case Report

A case of emphysematous hepatitis with spontaneous pneumoperitoneum in a patient with hilar cholangiocarcinoma: Jung Ho Kim, Eul Sik Jung, Seok Hoo Jeong, Ju Seung Kim, Yang Suh Ku, Ki Baik Hahm, Ju Hyun Kim, Yeon Suk Kim; Korean J Hepatol 2012;18(1):94-97.
Published online March 22, 2012; DOI: https://doi.org/10.3350/kjhep.2012.18.1.94

Abstract
PDF

An 80-year-old woman with hilar cholangiocarcinoma was hospitalized due to sudden-onset abdominal pain. Computed tomography revealed hepatic necrosis accompanied with emphysematous change in the superior segment of the right liver (S7/S8), implying spontaneous rupture, based on the presence of perihepatic free air. Although urgent percutaneous drainage was performed, neither pus nor fluids were drained. These findings suggest emphysematous hepatitis with a hepatic mass. Despite the application of intensive care, the patient's condition deteriorated rapidly, and she died 3 days after admission to hospital. Liver gas has been reported in some clinical diseases (e.g., liver abscess) to be caused by gas-forming organisms; however, emphysematous hepatitis simulating emphysematous pyelonephritis is very rare. The case reported here was of fatal emphysematous hepatitis in a patient with hilar cholangiocarcinoma.

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Liver Pathologys

Biliary intraepithelial neoplasia: a case with benign biliary stricture: Wonkyung Jung, Baek-hui Kim; Korean J Hepatol 2011;17(4):328-330.
Published online December 26, 2011; DOI: https://doi.org/10.3350/kjhep.2011.17.4.328

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A rare case of symptomatic grossly-visible biliary intraepithelial neoplasia mimicking cholangiocarcinoma
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Cholangiocarcinoma arising in von Meyenburg complexes: Hee Kyung Kim, So-Young Jin; Korean J Hepatol 2011;17(2):161-164.
Published online June 23, 2011; DOI: https://doi.org/10.3350/kjhep.2011.17.2.161

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Case Report

Detection of distant metastasis to skeletal muscle by ¹⁸F-FDG-PET in a case of intrahepatic cholangiocarcinoma: Se Kyung Park, Young Seok Kim, Sang Gyune Kim, Jae Young Jang, Jong Ho Moon, Moon Sung Lee, Boo Sung Kim, Eun Suk Koh, Jung Mi Park; Korean J Hepatol 2010;16(3):325-328.
Published online September 30, 2010; DOI: https://doi.org/10.3350/kjhep.2010.16.3.325

Abstract
PDF

Intrahepatic cholangiocarcinoma is a rare malignancy that originates from the epithelial cells of the intrahepatic bile ducts. Intrahepatic cholangiocarcinoma can metastasize in lymphatic chains, including the hepatoduodenal ligament, and it often invades adjacent organs or metastasizes to other visceral organs such as the lungs, bones, adrenal glands, and brain. However, distant skeletal muscle metastasis is very rare. Moreover, a metastatic skeletal muscle tumor rarely shows specific symptoms, making it difficult to identify in a routine examination. A 45-year-old man with a chief complaint of right upper quadrant abdominal pain was admitted to our hospital. Abdominal ultrasound and computed tomography with contrast enhancement showed a malignant mass in the right hepatic lobe, and 2-[¹⁸F] fluoro-2-deoxy-D-glucose positron-emission tomography revealed distant skeletal muscle metastases in the thorax and buttock. The patient underwent an ultrasound-guided percutaneous needle biopsy for the metastatic low-echo masses in the skeletal muscle.

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A Rare Axillary Lymph Node Metastasis on 18F-FDG PET/CT for Staging in a Patient with Common Bile Duct Cancer
Yeongjoo Lee, Hye Sung Won, Kyung Jin Seo, Sae Jung Na
Diagnostics.2023; 13(18): 3012. CrossRef
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Hongwei Qian, Zhikun Huang, Xuezheng Sun, Peitu Ren
Frontiers in Surgery.2022;[Epub] CrossRef
Skeletal muscle metastases of the trunk and pelvis: focus on ultrasound, CT findings, and clinical manifestations
So Yeon Cha, Hyun Su Kim, Ji Hyun Lee, Young Cheol Yoon
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Cholangiocarcinoma Metastasizing to the Breast: An Unknown Entity
Shraddha Patkar, M. Rajgopal Acharya, Ruchit Kansaria, Tanuja Seth, Aekta Shah, Mahesh Goel
Journal of Gastrointestinal Cancer.2020; 51(2): 654. CrossRef
Cholangiocarcinoma Presenting as Linitis Plastica with Unusual Metastases to the Psoas Muscle and Urinary Bladder
Debdeep Banerjee, Saikiran Raghavapuram, Nayana E. George, Soheila Korourian, Faysal A. Fedda, Abhilash Perisetti, Benjamin Tharian
ACG Case Reports Journal.2018; 5(1): e51. CrossRef
The Role of F-18 FDG PET/CT in Intrahepatic Cholangiocarcinoma
Yeongjoo Lee, Ie Ryung Yoo, Sun Ha Boo, Hyoungwoo Kim, Hye Lim Park, Joo Hyun O
Nuclear Medicine and Molecular Imaging.2017; 51(1): 69. CrossRef
Rapidly aggravated skeletal muscle metastases from an intrahepatic cholangiocarcinoma
Jiyoung Lee
World Journal of Gastroenterology.2015; 21(6): 1989. CrossRef
PET/CT imaging of skeletal muscle metastases
Alexey Surov, Maria Kerstin Pawelka, Andreas Wienke, Dominik Schramm
Acta Radiologica.2014; 55(1): 101. CrossRef
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Jasper Emmering, Wouter V. Vogel, Marcel P.M. Stokkel
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Sun Choon Song, Jin Seok Heo, Dong Wook Choi, Seong Ho Choi, Woo Seok Kim, Min Jung Kim
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The H4 histamine receptor agonist, clobenpropit, suppresses human cholangiocarcinoma progression by disruption of epithelial mesenchymal transition and tumor metastasis
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Hepatology.2011; 54(5): 1718. CrossRef

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Liver Pathologys

Intrahepatic cholangiocarcinoma associated with Clonorchis sinensis infection: Yoon Mi Jeen , So Young Jin; Korean J Hepatol 2009;15(4):524-527.
Published online December 31, 2009; DOI: https://doi.org/10.3350/kjhep.2009.15.4.524

Abstract
PDF

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A Case of Clonorchiasis with Focal Intrahepatic Duct Dilatation Mimicking an Intrahepatic Cholangiocarcinoma
Bong Gap Kim, Dae Hwan Kang, Cheol Woong Choi, Hyung Wook Kim, Jae Hyung Lee, Suk Hun Kim, Hye Ju Yeo, Soo Yong Lee
Clinical Endoscopy.2011; 44(1): 55. CrossRef

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Crossref

Mucin hypersecreting cholangiocarcinoma: Yoon Mi Jeen , So Young Jin; Korean J Hepatol 2008;14(4):532-536.
Published online December 31, 2008; DOI: https://doi.org/10.3350/kjhep.2008.14.4.532

5,062 View
17 Download

Combined Hepatocellular-cholangiocarcinoma: Yoon Mi Jeen , So Young Jin; Korean J Hepatol 2007;13(4):571-575.
Published online December 20, 2007; DOI: https://doi.org/10.3350/kjhep.2007.13.4.571

4,948 View
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Intrahepatic Cholangiocarcinoma associated with Hepatolithiasis: Yoon Mi Jeen , So Young Jin; Korean J Hepatol 2007;13(3):423-426.
Published online September 20, 2007; DOI: https://doi.org/10.3350/kjhep.2007.13.3.423

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Case Reports

A Case of Intrahepatic Cholangiocarcinoma in Polycystic Liver Disease: Jin Hee Son, M.D., So Young Kwon, M.D., Sung Wuk Song, M.D., Ju Hyup Yum, M.D., Ko Jae Min, M.D., Myung Soo Ahn, M.D. Kyung Woo Choi, M.D.*and Hee Jin Chang, M.D.**; Korean J Hepatol 1999;5(2):156-161.

Abstract
PDF

Cholangiocarcinoma has been associated with various fibrocystic diseases of liver and biliary tract, but cholangiocarcinoma in polycystic liver disease (PLD) was extremely rare. It was reported that the prognosis of cholangiocarcinoma associated PLD was very poor and distant metastases were common. We report a rare case of intrahepatic cholangiocarcinoma associated with PLD in 58-year-old female who presented vague abdominal pain. She had also polycystic kidneys with normal renal function. MRI showed well demonstrated tumor with central scar and a adjacent large cyst in the left lobe of the liver. She underwent extended left lobectomy. On microscopic examination, the tumor was moderately differentiated cholangiocarcinoma having abundant fibrous stroma and necrosis and the adjacent cyst showed focal in situ carcinomatous changes in the lining epithelium. (Korean J Hepatol 1999;5:156－161)

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Combined Hepatocellular and Cholangiocarcinoma , Separate Type - A Case Report: Ho Sung Park, Jeong Min Lee*, Hee Chul Yu†, Woo Sung Moon; Korean J Hepatol 2001;7(2):201-205.

Abstract
PDF

Combined hepatocellular and cholangiocarcinoma (cHCC-CC) is an uncommon form of primary liver cancer having features of both hepatocellular and billiary epithelial differentiation. We report a case of cHCC-CC that separately developed in a patient who was serologically positive for hepatitis B virus. A 36-year-old woman was diagnosed by ultrasonography with an asymptomatic tumor in the left lobe of the liver. Based on radiologic and serologic findings of elevated serum alpha-fetoprotein (AFP) level, a preoperative diagnosis of hepatocellular carcinoma was made. A left lobectomy of the liver was done. On histological examination, the resected tumor was shown to consist of two separated masses. One was hepatocellular carcinoma that showed immunoreactivity for AFP. The other was cholangio- carcinoma that showed immunoreactivity for cytokeratin-19 (CK-19) in a separate form. (Korean J Hepatol 2001;7:201-205)

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Liver Pathology

Intestinal Type of Cholangiocarcinoma Associated with Hepatolithiasis: Young Nyun Park,Chan Il park; Korean J Hepatol 2001;7(3):349-351.

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72세 남자환자는 3년간의 간헐적인 우상복부 동통과 발열을 주소로 내원하였다. ERCP 및 초음파 검사상 간내 결석과 종괴가 관찰되어 간엽절제술을 시행하였다. 환자의 혈청검사 소견은 AST/ALT 18/20 IU/L, alkaline phosphatase 140 IU/L, HBsAg(-), anti-HBs(+)였다. carcinoembryonic antigen, CA125 및 CA19-9는 정상 범주였다.

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Liver Imaging

Peripheral Cholangiocarcinoma: Joon Koo Han; Korean J Hepatol 2002;8(1):110-111.

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Liver Pathologys

Synchronous Hepatocellular Carcinoma and Cholangiocarcinoma Arising in Two Different Dysplastic Nodules: Young Mee Kwon,Seung Kyu Lee,Jung Sun Kim,Jae Y. Ro,Eun Sil Yu; Korean J Hepatol 2002;8(2):223-227.

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55세 여자 환자가 상복부 통증을 주소로 개인 의원으로 내원하여 B형 간염과 연관된 간경화로 진단받고 치료를 받기 위하여 본원으로 전원 되었다. 간 기능 검사상 AST/ALT 87/84 IU/L, alkaline phosphatase/r-GT 218/59 IU/L, α-fetoprotein 101 ng/mL이었다. HbsAg과 HbeAg은 양성이었고, HbsAb는 음성이었다. 그 외 혈청 및 소변 검사는 정상이었다. 복부 초음파와 전산화 단층 촬영상 복수 및 비장 비대와 함께 간경화의 소견을 보였다. 9개월 후 시행한 전산화 단층 촬영 상 간원개(hepatic dome)와 6번 분절에 조영 증강을 보이는 몇몇의 작은 결절이 발견되었다. 그로부터 5개월 후 추적 관찰한 전산화 단층 촬영 상 6번 분절에 조영 증강을 보이는 4.5 cm 크기의 종양이 발견되었고, 조영 증강을 보이는 또 다른 두 개의 결절이 8번 분절에서 발견되었고(그림 1A & 2A), 네번째의 결절이 3번 분절에서 발견되었다. 가장 큰 종양에 대해서 경동맥 화학주입요법을 시행받았고, 한 달 후 간이식을 받았다.

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Biliary Papillomatosis: Hyun Lyoung Koo,Eun Sil Yu; Korean J Hepatol 2002;8(3):336-339.

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Original Article

Evaluation of Various Hepatic Lesions with Positron Emission Tomography: Hyun Bae Son, M.D., Chul Ju Han, M.D., Beung Il Kim, M.D.*, Jin Kim, M.D., Sook-Hyang Jeong, M.D., You Cheoul Kim, M.D., Jhin Oh Lee, M.D., Chang Yun Choi, M.D.* and Sang Mu Im, M.D.*; Korean J Hepatol 2002;8(4):472-480.

Abstract
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Background/Aims
[¹⁸F]FDG-PET is a functional imaging modality reflecting cellular glucose metabolism. In most malignant cells, accumulation and trapping of [¹⁸F]FDG allows the visualization of increased uptake compared with normal cells. The aim of this study was to assess the value of PET in differentiating benign from malignant hepatic lesions and to determine in which types of hepatic tumors PET can help evaluate stage, monitor response to therapy, and detect recurrence. Methods: Eighty patients with liver lesions were enrolled (hepatocellular carcinoma 34, cholangiocarcinoma 8, metastatic liver cancer 25, hemangioma 6, liver abscess 7). Liver metastases were 22 adenocarcinoma, 2 lymphoma, 2 squamous cell carcinoma. The PET images of these patients were analyzed. SUV and lesion-to-normal liver background SUV ratio were obtained and compared among the disease groups. Results: All liver metastases and all cholangiocarcinomas had increased uptake value, with SUV ratios greater than 2. Hepatocellular carcinoma had SUV ratios greater than 2 in 20 of 34 patients (59%). All hemangiomas had poor uptake, a SUV ratio of less than 2. All liver abscesses showed definite uptake. Conclusions: The PET technique using FDG static imaging was useful in differentiating malignant from benign lesions of the liver in limited situations. Limitations included false negative results in some patients with hepatocellular carcinoma. Liver abscesses raised problems in differential diagnosis from malignant liver tumors. The findings of this study suggest that the PET technique might be applied in tumor staging and the detection of recurrence, as well as monitoring responses to therapy for all adenocarcinomas and some hepatocelluar carcinomas. (Korean J Hepatol 2002;8:472-480)

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Case Reports

A Case of Combined Hepatocellular-Cholangiocarcinoma with Sarcomatous Transformation and Second Primary Colon Cancer: Jae Hi Kim, M.D., Yong Gu Lee, M.D., Jun Lee, M.D., Cheol Kweon Jung, M.D., Hyeong Tae Kim, M.D., Haeyoun Kang, M.D.*, Kwang Hyun Kho, M.D., Sung Pyo Hong, M.D., Seong Gyu Hwang, M.D., Pil Won Park, M.D. and Gyu Sung Rim, M.D.; Korean J Hepatol 2004;10(2):142-147.

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Combined hepatocellular-cholangiocarcinoma is a rare form of primary liver cancer, featuring both hepatocellular and biliary epithelial differentiations. An intrahepatic tumor may be considered as a metastatic lesion. It has been suggested in the literature that the likelihood of metastasis in the cirrhotic liver is lower than that in the non-cirrhotic liver. A rare case of combined hepatocellular-cholangiocarcinoma and second primary colon adenocarcinoma in a 67-year-old male patient with liver cirrhosis is presented. Histologically, the intrahepatic mass was composed of a spindle cell sarcomatous component; a hepatocellular carcinoma component; and a cholangiocarcinoma component. There were focal transitional regions among the different components. Immunohistochemically, the cholangiocarcinoma component of the intrahepatic mass showed positive reaction for CK-7 but negative reactions for CK-20. The adenocarcinoma of the colon showed positive reactions for CK-20 but negative reactions for CK-7. (Korean J Hepatol 2004;10:142-147)

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A Case of Hepatocellular-cholangiocarcinoma Invading the Gallbladder: Kyung Young Namkoong, M.D., Myung Jin Kang, M.D., Hong Mok Im, M.D., Mi Sung Kim, M.D., Byung Sung Ko, M.D., Hyun Taek Ahn, M.D., Jong Riul Lee, M.D.* and Jong Ok Kim, M.D.; Korean J Hepatol 2004;10(2):148-153.

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Metastasis of hepatocellular carcinoma occurs at a relatively late stage of the disease. Hematogenous and lymphatic metastases are the most common routes for dissemination of tumor cells. Hepatocellular carcinoma also extends into the adjacent portal vein and bile ducts. Since there is no peritoneum between the body of the gallbladder and the liver fossa, gallbladder cancer can easily cross the boundary. Gallbladder invasion of hepatocellular carcinoma, however, is quite rare. We report a case of hepatocellular-cholangiocarcinoma in a non-cirrhotic liver that invaded the gallbladder mimicking the gallbladder carcinoma complicated by cholecystitis and liver abscess. (Korean J Hepatol 2004;10:148-153)

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Mucinous Cholangiocarcinoma associated with Clonorchis sinensis Infestation: A Case Report: Hyo Sup Shim*, Beom Jin Lim*, Myeong-Jin Kim , Woo Jung Lee , Chanil Park*, , and Young Nyun Park*,; Korean J Hepatol 2004;10(3):223-227.

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Mucinous cholangiocarcinoma, characterized by large quantities of mucin production, is a rare subtype of peripheral cholangiocarcinoma and usually shows rapid progression and a fatal outcome. We report here a case of mucinous cholangiocarcinom a in a 69 year-old man, who was infected with Clonorchis sinensis. Histologically, the tumor was an adenocarcinom a with extensive intracellular and extracellular mucin production, up to 70% of the tumor mass and there was frequent lymphovascular invasion of the tumor cells. The liver adjacent to the mass contained eggs of C lonorchis sinensis in the bile duct lumen and showed ductal epithelial hyperplasia, mucinous metaplasia and adenomatous proliferation of intramural glands. The patient was treated with a right hepatectomy. Four months after the surgery, the tumor recurred in the soft tissue of the right flank. (Korean J Hepatol 2004;10:223-227)

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Liver Imaging

Combined Hepatocellular-cholangiocarcinoma: Joon Koo Han , Se Hyung Kim , Soo Jin Kim; Korean J Hepatol 2007;13(1):112-115.

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Editorial

Review: Analysis of Survival Rate and Prognostic Factors of Intrahepatic Cholangiocarcinoma: 318 Cases in Single Institute: Woo Jin Lee , Joong Won Park; Korean J Hepatol 2007;13(2):125-128.

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Original Article

Analysis of Survival and Factors Affecting the Survival after Surgical Resection of Peripheral Cholangiocarcinoma: 318 Cases in Single Institute: Gi Won Song , Sung Gyu Lee , Young Joo Lee , Kwang Min Park , Shin Hwang , Ki Hun Kim , Chul Soo Ahn , Deok Bog Moon , Tae Yong Ha , Dong Hwan Jung; Korean J Hepatol 2007;13(2):208-221.

Abstract
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Backgrounds/Aims
Although the survival rate after surgical resection of peripheral cholangiocarcinoma is low, surgical resection is only potentially curative therapy. The aim of this study is to evaluate clinicopathological factors affecting survival after surgical resection of peripheral cholangiocarcinoma. Methods: Between February 1990 and December 2005, surgical intervention with curative intent was performed on 318 patients and 292 patients underwent resection. We retrospectively analyzed survival data of 318 patients and clinicopathological factors affecting survival by reviewing the medical record. Results: Among the 292 cases of resection, curative resection with tumor-free margin (R0) has been resulted in 221 cases. The 1-, 3-, 5- and 10-year survival rate of R0 resection were 74.9, 46.9, 36.9 and 15.2%, respectively. The survival rate of patient undergoing R0 resection was significantly better than that of R1, R2 or nonresection. Multivariate analysis showed that curative resectability, macroscopic type of tumor and lymph node metastasis were statically significant independent prognostic factors. Conclusions: The survival after surgical resection of peripheral cholangiocarcinoma depends on curability of surgical resection, macroscopic type of tumor and status of lymph node. Particullary in R0 resection for intraductal growth type without lymph node metastasis, there is great chance for long-term survival. Surgical resection attaining tumor free margin should be attempted if liver function and general condition of patient are acceptable for hepatectomy. (Korean J Hepatol 2007;13:208-221)

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Liver Pathology

Papillary Cholangiocarcinoma Arising from Biliary Papillomatosis: Yoon Mi Jeen , So Young Jin; Korean J Hepatol 2007;13(2):239-242.

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Liver Imaging

Intraductal Papillary Mucinous Cholangiocarcinoma: Joon Koo Han , Se Hyung Kim , Soo Jin Kim; Korean J Hepatol 2007;13(2):243-247.

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