Intrahepatic Cholangiocarcinoma

Intrahepatic Cholangiocarcinoma

Matthew M. Yeh, MD, PhD

Intrahepatic cholangiocarcinomas generally arise in noncirrhotic livers. This gross photograph shows a white-tan, firm, and distinct mass in a background of noncirrhotic liver.

Intrahepatic cholangiocarcinomas form irregular glandular structures with an infiltrative appearance, surrounded by a prominent stroma. The nuclei are hyperchromatic and pleomorphic.



  • Malignant adenocarcinoma arising from bile duct epithelium within liver


Multistep Carcinogenesis

  • Chronic inflammation may be common pathogenic pathway



  • Age

    • Average age at presentation is 60 years old

  • Gender

    • Equal frequency in men and women

  • Ethnicity

    • Very prevalent in Asia, particularly in northeastern Thailand (associated with liver fluke infestation)


  • 10-20% of primary liver malignancies

    • Incidence and mortality rates have been increasing in several regions around world

    • Incidence has also increased 3x in past few decades in USA

  • Most patients are diagnosed with advanced stages of disease

  • Symptoms

    • Abdominal pain

    • Weight loss

    • Malaise

    • Jaundice

Laboratory Tests

  • Serum level of CA19-9 is currently most important tumor marker

  • Alkaline phosphatase and bilirubin variably elevated


  • Long-term survival is dismal

Risk Factors

Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Intrahepatic Cholangiocarcinoma
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