The Experts below are selected from a list of 63 Experts worldwide ranked by ideXlab platform
Masato Nagino - One of the best experts on this subject based on the ideXlab platform.
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new classification of cystic duct carcinoma
World Journal of Surgery, 2008Co-Authors: Yukihiro Yokoyama, Hideki Nishio, Tomoki Ebata, Tsuyoshi Igami, Yuji Nimura, Masato NaginoAbstract:Background Farrar’s criteria for cystic duct carcinoma (histopathologic diagnosis of a carcinoma strictly limited to the cystic duct) are impractical especially when making a diagnosis of primary cystic duct carcinoma in its advanced stage. Therefore, in our previous study, we proposed a new definition of cystic duct carcinoma: a Gallbladder Tumor, the center of which is located in the cystic duct. In this study, we further propose a new classification for cystic duct carcinomas diagnosed by our definition.
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cystic duct carcinoma a proposal for a new working definition
Langenbeck's Archives of Surgery, 2003Co-Authors: Ilgin Ozden, Masato Nagino, Junichi Kamiya, Katsuhiko Uesaka, Tsuyoshi Sano, Satoshi Kamiya, Yuji NimuraAbstract:Background: Farrar's cri- teria for cystic duct carcinoma (histo- pathological diagnosis of a carcino- ma strictly limited to the cystic duct) have practical limitations. We pro- pose new "working definition": a Gallbladder Tumor, the center of which is located in the cystic duct. Patients and methods: Between 1980 and 2000 we diagnosed cystic duct carcinoma in 31 patients, 28 of whom (90%) had increased serum bilirubin concentrations. Extrahepatic bile duct resection and cholecystecto- my were performed in 10 patients; in others, extended right hepatectomy (16), right hepatectomy (3), and liver bed resection (2) were necessary as well for a potentially curative resec- tion. Additional procedures were por- tal vein resection (10) and pancreato- duodenectomy (7). Results: All tu- mors were adenocarcinomas. Depth of invasion was T2 in 3 patients, T3 in 12, and T4 in 16. Thirteen patients (42%) had lymph node metastasis. Curative resection was performed in 24 patients (77%). Hospital mortality was 5 of 31 (16%). Actuarial 5-year survival rate excluding hospital deaths was 22%. Conclusions: The proposed "working definition" avoids the problems associated with Farrar's criteria and describes a dis- tinct patient group with an approxi- mately equal proportion of men and women, advanced T stage, but a low- er than expected frequency of lymph node metastasis. It establishes a basis for standard reporting of results.
Zachary Goodman - One of the best experts on this subject based on the ideXlab platform.
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Giant cell Tumor of the extrahepatic biliary tree : A clinicopathologic study of 4 cases and comparison with anaplastic spindle and giant cell carcinoma with osteoclast-like giant cells
The American Journal of Surgical Pathology, 2006Co-Authors: Jorge Albores-saavedra, Douglas J. Grider, Donald E. Henson, Zachary GoodmanAbstract:We report four previously undescribed primary giant cell Tumors of the extrahepatic biliary tree and morphologically compare them with 10 anaplastic spindle and giant cell carcinomas with osteoclast-like giant cells of the Gallbladder. Two giant cell Tumors were located in the distal common bile duct; one in the cystic duct and one in the Gallbladder. The 3 patients with bile duct Tumors were male, and the only patient with a Gallbladder Tumor was a female. The age of the patients ranged from 45 to 60 years with an average of 55 years. The patients with bile duct Tumors presented with biliary obstruction, and the patient with a Gallbladder Tumor presented with symptoms of cholelithiasis and a Gallbladder mass. Histologically, the Tumors were similar to giant cell Tumors of bone. They consisted of a mixture of mononuclear and multinucleated osteoclast-like giant cells. The mononuclear cells showed no atypical features, and their nuclei were similar to those of the multinucleated giant cells. CD163 immunoreactivity was restricted to the mononuclear cells, whereas CD68 and HAM 56 labeled only the multinucleated osteoclast-like giant cells. The mononuclear cells were EMA-positive but did not express cytokeratins. Follow-up showed that 3 patients were alive and disease-free 3.7 to 7 years after surgery. The anaplastic spindle and giant cell carcinomas contained a fewer number of osteoclast-like giant cells, and their mononuclear cells showed considerable variation in size and shape, marked cytologic atypia, and numerous mitotic figures. They were focally cytokeratin positive (AE1/AE3; CAM 5.2) and did not label with CD163, CD68, and HAM 56. The benign osteoclast-like giant cells showed immunoreactivity for CD68 and HAM 56 but were negative for CD163 and cytokeratins. Giant cell Tumors of the extrahepatic biliary tree are benign true histiocytic neoplasms that should be distinguished from the highly lethal anaplastic spindle and giant cell carcinomas with osteoclast-like giant cells by detailed cytologic analysis and immunohistochemical stains for CD163, CD68, HAM 56, and cytokeratins.
Jorge Alboressaavedra - One of the best experts on this subject based on the ideXlab platform.
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clear cell carcinomas of the Gallbladder and extrahepatic bile ducts
The American Journal of Surgical Pathology, 1995Co-Authors: Celeste Vardaman, Jorge AlboressaavedraAbstract:Although clear cell carcinomas have been described in numerous anatomic sites, their occurrence in the Gallbladder and extrahepatic bile ducts (EHBD) is practically unknown. We report 10 such cases. Seven arose in the Gallbladder and three in the EHBD; all patients with Gallbladder Tumors were females with cholelithiasis whose ages ranged from 56 to 68 years. Patients with EHBD Tumors were younger (38 and 40 years of age) and had extrahepatic biliary obstruction and abdominal pain. Two patients with Gallbladder carcinomas had elevated serum carcinoembryonic antigen (CEA) levels, and another without hepatic involvement had markedly elevated circulating levels of alpha-fetoprotein (AFP). Histologically, nine Tumors were adenocarcinomas and one was a squamous cell carcinoma. Seven adenocarcinomas consisted of cords, sheets, nests, papillae, and trabeculae of clear cells with well-defined cytoplasmic borders. Two were composed predominantly of glands and papillary structures. The cells contained PAS-positive diastase-labile granules and were cytokeratin- and EMA-positive and immunoreactive for erythropoiesis-associated antigen. One Gallbladder Tumor contained areas of hepatoid differentiation, a feature described in Gallbladder neoplasms only once before. These areas were AFP-positive and immunoreactive for CEA. By electron microscopy, they showed hepatoid differentiation with formation of bile canaliculi. In two Gallbladder Tumors, neoplastic cells contained subnuclear vacuoles reminiscent of early secretory endometrium. Foci of conventional adenocarcinoma or mucinous carcinoma were recognized in all nine Tumors. The squamous cell carcinoma showed only foci of squamous differentiation with keratinization. The clear cells of this neoplasm had a trabecular and solid growth pattern. These clear cell neoplasms of the Gallbladder and EHBD must be differentiated from metastatic renal cell carcinoma, based upon the presence of areas of conventional adenocarcinoma or foci of squamous differentiation since results of special stains and immunohistochemistry are similar in both neoplasms. One of the patients with EHBD carcinoma is alive and symptom-free 6 years following right hepatic lobectomy. Five patients with Gallbladder Tumors had direct extension into the liver and died with metastases. Two are living with metastases.
Hirochika Yamada - One of the best experts on this subject based on the ideXlab platform.
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an extrahepatic bile duct metastasis from a Gallbladder cancer mimicking mirizzi s syndrome
The American Journal of Gastroenterology, 1999Co-Authors: Hiroto Akiyama, Tatsuro Sato, Sumio Toyoda, Hirochika YamadaAbstract:We report a case of an extrahepatic bile duct metastasis from a Gallbladder cancer that mimicked Mirizzi's syndrome on cholangiography. A 67-yr-old woman was admitted to our hospital with a diagnosis of acute calculous cholecystitis. As obstructive jaundice developed after the admission, percutaneous transhepatic biliary drainage was performed to ameliorate the jaundice and to evaluate the biliary system. Tube cholangiography revealed bile duct obstruction at the hepatic hilus, and extrinsic compression of the lateral aspect of the common hepatic duct, with nonvisualization of the Gallbladder. No impacted cystic duct stone was visualized on CT or ultrasonography. Laparotomy revealed a Gallbladder Tumor as well as an extrahepatic bile duct Tumor. We diagnosed that the latter was a metastasis from the Gallbladder cancer, based on the histopathological features. This case is unique in that the extrahepatic bile duct metastasis obstructed both the common hepatic duct and the cystic duct, giving the appearance of Mirizzi's syndrome on cholangiography. Metastatic bile duct Tumors that mimic Mirizzi's syndrome have not been previously reported. The presence of this condition should be suspected in patients with the cholangiographic features of Mirizzi's syndrome, when the CT or ultrasonographic findings fail to demonstrate an impacted cystic duct stone.
Yukihiro Yokoyama - One of the best experts on this subject based on the ideXlab platform.
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new classification of cystic duct carcinoma
World Journal of Surgery, 2008Co-Authors: Yukihiro Yokoyama, Hideki Nishio, Tomoki Ebata, Tsuyoshi Igami, Yuji Nimura, Masato NaginoAbstract:Background Farrar’s criteria for cystic duct carcinoma (histopathologic diagnosis of a carcinoma strictly limited to the cystic duct) are impractical especially when making a diagnosis of primary cystic duct carcinoma in its advanced stage. Therefore, in our previous study, we proposed a new definition of cystic duct carcinoma: a Gallbladder Tumor, the center of which is located in the cystic duct. In this study, we further propose a new classification for cystic duct carcinomas diagnosed by our definition.
